Lung cancer affects millions worldwide, but it’s not just a concern for older adults; it can impact teens and young adults too. Whilst rare, lung cancer in younger people is often misdiagnosed or detected late. Early diagnosis is key to improving outcomes. This blog explores lung cancer in young people, including risk factors, symptoms, and detection methods.
How Common Is Pediatric Lung Cancer?
Pediatric lung cancer is quite rare, representing around 0.2 percent of all cancers diagnosed in children each year in the United States1. However, in the last ten years, the number of children diagnosed with this type of cancer has doubled, with a study reporting the mean patient age being 13.2 years for the pediatric population2.
Lung cancer in teens (15–19)
In the United States, between 5,000 to 6,000 teens are diagnosed with cancer each year3. While lung cancer in teens is rare, it’s still a serious concern. A study found that in 301 cases of lung cancer reported, 139 of those cases were in teens aged 15 to 194.
Lung cancer in young adults (20s)
Lung cancer is slightly more common in young adults in their 20s than in teens. Unfortunately, it is often misdiagnosed or caught at a late stage. Take the case of a 20-year-old who had never smoked but started experiencing troubling symptoms like a persistent cough, lower back pain, and the loss of 24 lbs5. At first, a chest X-ray led to a pneumonia diagnosis. But when symptoms didn't improve, a computed tomography (CT) scan revealed metastatic lung adenocarcinoma- a type of cancer that had already spread5.
Data gaps and underreporting
There are low detection rates of lung cancer in teens and young adults due to a lack of screening protocols. The best way to detect lung cancer is to be aware of the symptoms and to detect lung cancer early.
What Causes Lung Cancer in Young People?
The most widely recognized risk factor for lung cancer is the use of tobacco. In recent years, the use of e-cigarettes and vaping, especially in the younger population, has raised concerns about the potential risk of lung cancer in the future. In the United States, a study found that over 1.63 million middle school and high school students were currently using e-cigarettes6. Exposure to secondhand smoke in children and young adults also increases the risk of developing lung-related issues, including lung cancer.
Environmental factors can also contribute to the risk of lung cancer in the younger population. These include early exposure to certain metals, asbestos, air pollution, radon gas, and some harmful chemicals. Family history and specific genetic mutations may also increase the risk of developing lung cancer.
Sometimes a combination of factors leads to lung cancer development, however, one study has reported that 82 of 8,734 patients with non-small cell lung cancer (NSCLC) or small cell lung cancer were under the age of 35, with 72 percent never having smoked, and 98 percent had no family history of lung cancer. These findings highlight why it is becoming increasingly important to be proactive about your own health7.
Can teens get lung cancer?
Teens can develop lung cancer, although considered more rare than in adults. Serious lung cancer diagnoses have been reported in teens. For example, one case study has shown that an 18-year-old patient with a cough, 60 lb of weight loss, and chest tightness was diagnosed with small cell lung cancer, a particularly aggressive form of cancer8. Lung cancer in teens comes with its challenges, due to the symptoms being similar to other health conditions. This often leads to misdiagnoses and underdetection.
Genetic predisposition and inherited conditions
Lung cancer can sometimes be genetic. If someone in the family has had lung cancer, there may be a risk of someone in their family also developing the condition. Genetic mutations like those in BRCA1 and EGFR genes can also increase the likelihood of developing lung cancer, and conditions such as Li-Fraumeni syndrome may also increase the risk. Having these risk factors doesn’t mean you will definitely get lung cancer, some people with these factors may never develop the disease. Staying informed about your health and any family history is always the best way to be proactive about your health.
Environmental exposures & lifestyle factors
Smoking is one of the highest risk factors for lung cancer. In recent years, many teens and young adults have used tobacco products, including e-cigarettes and vaping. Secondhand smoke can also increase the risk of developing this disease. Other factors include exposure to asbestos, metals (chromium, cadmium, and arsenic), air pollution, and radon gas.
Symptoms and Early Warning Signs
Common symptoms in young people
If you suffer symptoms of lung cancer, you should contact your healthcare provider. These symptoms include:
- Persistent cough
- Chest pain
- Shortness of breath
- Unexplained weight loss
- Coughing up blood
- Fatigue
Symptoms that often get overlooked
Symptoms such as fatigue, weight loss, cough, and chest pain are similar to other health conditions, such as pneumonia and asthma, often leading to misdiagnoses of lung cancer.
When to seek help
The best way for early detection of lung cancer is to listen to your own body and advocate for testing when you feel something isn’t right. The best course of action when it comes to your health is to trust your instincts when symptoms arise. It is crucial to discuss symptoms with a healthcare professional and seek help. Early detection significantly improves survival rates.
Types of Lung Cancer Seen in Teens and Young Adults
Non-small cell lung cancer (NSCLC)
The most common type of lung cancer is NSCLC, even in the young population. NSCLC is a type of cancer that develops in the cells (epithelial cells) that line the airways and air sacs of the lungs. The three main types of NSCLC include adenocarcinoma, large cell carcinoma, and squamous cell carcinoma. Common symptoms of NSCLC can include chest pain, cough, and fatigue.
Small cell lung cancer
Small cell lung cancer is a more aggressive form of lung cancer. While it’s less common in younger people, it can still occur. Symptoms can include cough, shortness of breath, and weight loss. Given its aggressive nature and ability to spread quickly, early detection is essential to improve outcomes.
Diagnosis and Imaging
How lung cancer is diagnosed
Lung cancer diagnosis typically begins with a physical exam from your healthcare provider, followed by imaging tests. These include CT scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans. A bronchoscopy and/or biopsy are then conducted to take a sample of the lung tissue to look for cancer cells.
Why it's harder to catch early in young people
Symptoms of lung cancer are often mistaken for other health conditions such as asthma or infections. Due to how rare lung cancer is in the young population, it’s possible that healthcare providers may not initially consider it as a diagnosis. Being aware of the symptoms and advocating for your health is essential for early detection and treatment.
Ezra’s role in early detection
At Ezra, we offer safe and painless CT and AI-assisted full-body MRI scans. Our scans are ultra-sensitive, accurate, and provide fast results with the ability to detect potential abnormalities in up to 13 organs, including the lungs. Our full-body MRI scan can provide early detection imaging even in young individuals. If you or someone you know is experiencing symptoms of lung cancer or is at high risk of developing lung cancer, speak to your healthcare provider and consider booking our full-body MRI scan.
Treatment Options
Surgery and early-stage treatment
Early detection of lung cancer can drastically improve survival rates. Lung cancer is often treated with surgery, including:
- Lung surgery: thoracotomy
- Minimally invasive surgery: video-assisted thoracoscopic surgery (VATS) or robotic-assisted thoracoscopic surgery (RATS).
The most common surgery during early-stage treatment is VATS, involving smaller incisions and less time in hospital9.
Chemotherapy, radiation, and immunotherapy
Typically for late-stage lung cancer (stage III or IV), chemotherapy, radiation, and immunotherapy treatment options are considered. Treatment regimes vary for each individual and depend on the type of cancer, stage, and spread.
Clinical trials and evolving therapies
One of the most recently approved cancer therapies, which is transforming the landscape of cancer treatment, is antibody-drug conjugates (ADCs). Trastuzumab was the first ADC approved for NSCLC that works by targeting HER2-mutated tumors10. It delivers cell-killing drugs directly to HER2-expressing cancer cells, reducing the damage to healthy tissue.
Survival Rates and Prognosis
Lung cancer in young adults survival rate
The overall survival rates in young adults diagnosed with lung cancer can vary depending on the cancer type. A study focused on lung cancer cases in individuals aged 19 and younger revealed a concerning trend; the 10-year survival rates ranged from 52 - 74 percent from 2005 to 2016. This has declined compared to the 82 - 93 percent seen from 1975 to 20042.
Impact of early diagnosis
Catching lung cancer early makes a significant difference when it comes to successful treatment. When detected early, treatment opttions are less severe, including surgery to remove the cancer. If found late, the cancer could be inoperable and treatments may be more aggressive involing chemotherapy, radiation, and immunotherapy. It is important to be aware of the signs and symptoms of lung cancer and seek early detection to get the best chance of successful treatment.
Emotional & social support
Facing a cancer diagnosis isn't easy for anyone, but can be especially overwhelming for teens and young adults. During this journey, seeking emotional and social support is crucial. Connecting with mental health support groups, peer support networks, and healthcare providers can offer guidance and support throughout the cancer journey. Remember, mental health is just as important as physical health.
Conclusion
Lung cancer, although relatively rare, remains a significant challenge in the teen and young adult population. The signs and symptoms of lung cancer in teens and young adults are often overlooked or misdiagnosed, making early diagnosis and effective treatment even more difficult. Teens and young adults can be affected by many lung cancer risk factors, yet lung cancer can occur even without these risk factors. The greatest challenge with cancer is its invisibility. Being proactive in recognizing symptoms of lung cancer and seeking early screening is the best approach to take for all age groups.
If you want to be proactive about your health, why not book an Ezra Full Body MRI? Our scan checks for potential signs of cancer in up to 13 organs and 500+ conditions—quickly and painlessly. Book your scan today.
