The impact of age at presentation on lung cancer staging

BACKGROUND: Primary lung cancer is one of the most common causes of cancer and of death due to cancer worldwide. The tumour node metastases staging for non-small-cell lung cancer (NSCLC) helps to prognosticate and plan for treatment. Most patients have advanced disease at the time of diagnosis. Primary lung malignancy was previously diagnosed mostly in older individuals. OBJECTIVES: The primary aim of this study was to determine whether younger age at presentation is a risk factor for more advanced disease. We defined younger age as <45 years. METHODS: This was a retrospective analytical study covering 5.5 years. The information was obtained from the lung cancer registry of all patients presented at our Division of Pulmonology weekly combined oncology meeting. RESULTS: A total of 52 of 1 083 patients with lung malignancy were <45 years, and 48 of these had NSCLC. Adenocarcinoma was the predominant type (48%), followed by squamous cell carcinoma (27%), NSCLC not otherwise specified (NOS; 21%) and large-cell carcinoma (4%). Overall, the majority of patients (98%) had advanced disease at presentation. However, there was no statistical difference compared with presenting stage in older patients (odds ratio 0.25, 95% confidence interval (CI) 0.034 - 1.874 and risk ratio 0.27 (95% CI (0.038 - 1.900)). CONCLUSION: Primary lung malignancy remains a disease of the elderly. This study demonstrated that NSCLC tends to present in advanced stages in younger patients, although the difference was not statistically significant.