Lung Cancer Harder to Diagnose in Younger Patients

This article was originally published at About.com on January 10th, 2013 by Lynne Eldridge, MD.
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Studies have shown that when it comes to breast cancer, older women are more likely to be diagnosed with advanced stages of the disease.

Not so with lung cancer - at least in recent studies in Denmark and England. Instead, it seems the slogan reads "early age later stage."

Researchers in Denmark set out to evaluate the stage of lung cancer at which different age groups are diagnosed. Looking at people aged 65-69, those aged 70 to 74 were 18% less likely to be diagnosed with late stage disease. The trend continued on: Those aged 75 to 79 were 26% less likely, 80 to 84 were 27% less likely, and those over 85, 34% less likely to have a diagnosis of late disease. Since the stage at diagnosis makes a tremendous difference in long-term survival from lung cancer, this is something to stand up and take note of.

Why would younger people be less likely to diagnosed with lung cancer until it's reached the later stages of the disease? Or to ask the question in another way: Why does age seem to have a protective effect against late stage lung cancer diagnosis? Possibilities shared with me by Georogios Lyratzopoulous MD, one of the investigators in another study in England demonstating "early age later stage" include:

• There may be more "opportunistic" diagnosis among the older patients. This means that since older patients have more medical conditions, they are more likely to have their lung cancers "accidentally" diagnosed when a scan is done for some other reason.
  
• Young people may tolerate lung cancer symptoms more resiliently. This means that younger people may be able to "get by" or ignore lung cancer symptoms such as shortness of breath longer before they consult a doctor.
  
• My own speculation was that perhaps older people are more familiar with the symptoms that could be lung cancer by virtue of having had friends and acquaintances who have had lung cancer.
  

The conclusion based on these findings is that efforts to diagnose lung cancer early need to be tailored to different age groups. The stage of a lung cancer at the time of diagnosis can have a huge impact on younger patients with lung cancer. In the study above from Denmark, only 17% of the cancers were diagnosed at stage 1 and stage 2. To tailor the diagnostic process for different age groups, we need to focus on more diagnostic research instead of just treatment research.

Sources:

• Dalton, S. et al. Socioeconomic position, stage of lung cancer and time between referral and diagnosis in Denmark, 2001-2008. British Journal of Cancer. 2011. 105(7):1042-8.
  
• Lyratzopoulos, G. et al. Variation in advanced stage at diagnosis of lung cancer female breast cancer in an English Region 2006-2009. British Journal of Cancer. 2012. 106(6):1068-75.
  

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