Lung cancer in patients under 50 years old

Purpose: The community based lung cancer registry was set up and the result s were analysed to assess the differences in clinicopathological parameters and survival between patients under and over 50 years of age. Patients and methods: The Pulmonary Outpatient Clinics supplied the data on 5404 lung c ancer patients diagnosed in Poland in 1995. Data regarding demographic, smo king, histology, clinical stage, performance status, family history of canc er, therapy and Survival were obtained. Results: At time of diagnosis 757 ( 14%) patients were under 50 years of age. In this group the frequency of fe males was higher as compared to this in the group of older patients (24.2% vs. 12.1%; P < 0.001). Also the incidence of adenocarcinoma (12.6% vs. 7.6% ; P < 0.001) and small cell lung cancer (22.9% vs. 14.8%; P < 0.001) were s ignificantly higher in younger patients. Young patients had better performa nce status (55.4% vs. 46.6%; P < 0.001) than old. The incidence of cancer i n families of younger patients was higher both among the mothers (4.7% vs. 3.0%; P < 0.001) and among the fathers (7.6% vs. 4.1%, P < 0.001). Surgery or chemotherapy were more often applied to patients under 50 years in compa rison to older ones (P < 0.001). Young patients had better prognosis. Highe r percentage of them survived one year (32.6% vs. 28.9%; P < 0.049). In mul tivariate analysis, age over 50 at diagnosis, male gender, diagnosis of sma ll cell lung cancer, advanced stage of the disease, bad performance status, and non-surgical therapy were independent negative prognostic factors. Con clusion: Among young patients, overrepresentation of women, subjects with p ositive family history of cancer, with better performance status, with aden ocarcinoma and small cell lung cancer were noticed. Young patients were tre ated more aggressively and had better prognosis than patients over 50 years of age. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.