International patterns and incidence trends of lung cancer in adolescent and young adults by histological subtype and sex.
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BACKGROUND: Lung cancer in adolescents and young adults (AYAs) presents distinct features compared to older populations. METHODS: This population-based study utilized GLOBOCAN 2022 data to estimate lung cancer age-standardized incidence rates (ASIR) and mortality rates (ASMR) in individuals aged 15-39 years across 185 countries. Temporal trends in incidence stratified by histological subtype and sex (2003-2017) were analyzed using high-quality data from Cancer Incidence in Five Continents (CI5). We evaluated associations between disease burden and the Human Development Index (HDI) and calculated Average Annual Percentage Changes (AAPC) using Joinpoint regression. RESULTS: In 2022, an estimated 31,681 new lung cancer cases and 15,189 deaths occurred among AYAs globally, with Asia accounting for 78.3% of cases and 74.2% of deaths. Incidence was positively correlated with HDI (ρ=0.390, P < 0.001), while mortality showed no significant correlation. From 2003 to 2017, temporal analysis revealed stable or declining overall incidence in males. Conversely, incidence significantly increased among females in China, India, Japan, Austria, Belarus, and Australia. Notably, the incidence of adenocarcinoma rose significantly: the increase was observed in both sexes in countries such as China, the Republic of Korea, and the UK; in females only in India, the Netherlands, and Thailand; and in males only in Australia. CONCLUSION: Lung cancer incidence among AYAs varied by population, sex, and histological subtype, with increases in female incidence and adenocarcinoma incidence in several registry populations. These descriptive findings identify priorities for etiological research integrating individual-level exposure data, molecular characteristics, and information on diagnostic practices.