Lung cancer is often associated with older individuals. While rare, its occurrence in people in their 20s raises questions about its prevalence and unique considerations for this age group.
Prevalence in Young Adults
Lung cancer is uncommon in individuals in their 20s, with incidence rates significantly lower compared to older age groups. Studies indicate that only about 1.4% of lung cancer cases occur in people aged 35 and younger. Another analysis found lung cancer in young individuals (18-35 years) to have an incidence of 1.37% within a registry. The average age for a lung cancer diagnosis is around 70 years, with the majority of cases (approximately 53%) occurring in adults aged 55 to 74.
The rarity of lung cancer in young adults is largely due to the cumulative nature of the disease. It typically takes many years of exposure to carcinogens or for genetic mutations to accumulate and lead to cancer development.
For example, lung cancer incidence in adolescents and young adults (AYA) has seen a long-term decrease, dropping from 0.9 per 100,000 in 1975 to 0.4 per 100,000 in 2010 for females, with a similar pattern for males.
Contributing Factors for Early Onset
Lung cancer can develop in younger individuals due to a combination of factors. Genetic predispositions play a role, as certain inherited mutations can increase susceptibility to the disease, even without extensive environmental exposure. A family history of early-onset cancers, particularly lung cancer, can elevate risk. Specific genetic variants, such as those in the TP53 or EGFR genes, have been linked to lung cancer development.
Exposure to environmental carcinogens also contributes. Secondhand smoke, even from childhood exposure, is a known risk factor. Radon, an odorless gas released from soil, is another significant environmental cause, being the second leading cause of lung cancer after smoking. Air pollution and occupational exposures to chemicals, solvents, or toxins can also damage the lungs.
Certain types of lung cancer, such as adenocarcinoma, are more prevalent in younger patients. While heavy smoking is less common in individuals in their 20s, lung cancer can occur in young adults who have never smoked.
Recognizing Potential Indicators
Recognizing potential indicators of lung cancer in younger individuals is important, though these symptoms often overlap with more common, less serious conditions. A persistent cough that does not resolve or worsens over time is a primary symptom, including a chronic cough lasting more than three weeks or a change in its character.
Other signs include shortness of breath, even during routine activities. Chest pain or discomfort, particularly pain worse with deep breathing, coughing, or laughing, can also be a symptom. Unexplained weight loss and fatigue can also manifest, as the disease affects the body’s metabolism.
Recurrent respiratory infections, such as pneumonia or bronchitis, that do not improve with treatment or keep coming back, could signal an underlying issue like an airway obstruction from a tumor. While these symptoms warrant medical attention, especially if persistent, they are frequently indicative of other conditions.
Diagnosis in Younger Individuals
The diagnosis of lung cancer in young adults involves medical evaluations similar to those for older patients. An initial doctor’s visit for persistent symptoms includes a medical history review and physical exam. Imaging tests are often the first step to look for lung abnormalities; CT scans are more effective than X-rays at detecting tumors and showing their characteristics. MRI and PET scans can also provide detailed information, especially regarding potential spread.
A definitive diagnosis requires a biopsy, where tissue or fluid samples are collected and examined for cancer cells. Biopsy methods include needle biopsies, guided into suspicious areas, or bronchoscopy, where a thin tube with a camera is inserted into the airways.
Diagnosis in younger individuals can sometimes be delayed due to the disease’s rarity. Symptoms may be initially attributed to more common, less serious conditions, leading to misdiagnosis. This delay can result in a diagnosis at a more advanced stage. Therefore, thorough evaluation for persistent symptoms, regardless of age, remains important for timely detection.