Lung cancer in young adults

lung cancer young patients

Prof. dr. G.H. de Bock
H.J.M. Groen

Nature of the research:
clinical, database

Fields of study:
epidemiology oncology

Background / introduction
Background: Different factors are involved in the aetiology of lung cancer. Smoking, COPD, asbestos exposition, air pollution such as fine particles with an aerodynamic diameter of 10 (PM10) or even 2,5 micrometer, and genetic factors [Molina 2008, Pleasance 2010]. Smoking is the most important factor, especially for the development of small-cell lung cancer and squamous cell lung cancer. For adenocarcinomas next to smoking is fine particle air pollution. According to a large European study the risk for lung cancer is associated with particle air-pollution (HR 1,22; 95% BI., 1,03-1,45) per 10 μg/m3 increase in PM10. This risk seems however lower than the risk of smoking. The relative risk due to smoking is 23,3 en 12,7 for respectively men and women [Raaschou-Nielsen 2013]. However, the total risk of air pollution may be large due to continuous exposure by a larger population. The risk for developing lung cancer is attributed in 80 to 85% to smoking and in about 8% to particle air pollution, particularly for adenocarcinomas [WHO 2009; Beelen 2014]. Overall, 10% of smokers develop lung cancer. Smokers and non-smokers develop different lung cancers having a different spectrum of DNA mutations and different tumor mutation burden. Though lung cancer is a disease of the elderly and heavy smokers, it also occurs in younger patients who never smoked. The average age of having a diagnosis of lung cancer is about 65. We arbitrarily defined a diagnosis of “lung cancer in a young patient”, when that patient is under the age of 50. Though there are some studies in this field that suggest genomic aberrations due to radiation or small-particle pollution, it is still a rather underdeveloped area.
Research question / problem definition
The aim of the here proposed study is to evaluate the clinical and pathological, and genomic characteristics of young patients with lung cancer as compared to the older ones with the aim to further study the tumour biology; to evaluate differences in risk factors (family history and lifestyle); and to evaluate differences in outcomes (survival, response to therapy, recurrence risk, complications, Quality of Life).
This study will be performed by using samples from OncoLifeS, a databiobank including patients diagnosed with cancer embedded in the UMCG. This study is part of a larger study in which the aim is to evaluate the impact of age on healthy cancer survivorship: middle versus high income country. This is a cooperation between Faculdade de Medicina da University Sao Paulo, Sao Paulo (Brazil) and the University Medical Center Groningen, Groningen (The Netherlands).
Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc 2008; 83: 584-94.
Pleasance ED, Stephens PJ, O'Meara S, et al. A small-cell lung cancer genome with complex signatures of tobacco exposure. Nature 2010; 463: 184-90.
Raaschou-Nielsen O, Andersen ZJ, Beelen R, et al. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol 2013; 14: 813-22.
Beelen R, Stafoggia M, Raaschou-Nielsen O, et al. Long-term exposure to air pollution and cardiovascular mortality: an analysis of 22 European cohorts. Epidemiology 2014; 25: 368-78.
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Laatst gewijzigd: 23 februari 2012