How Lung Cancer Affects Different Age Groups

Lung cancer is the leading cause of cancer deaths in both men and women in the United States.

While breast cancer is the most commonly diagnosed cancer in women, and prostate cancer in men, the diagnosis of lung cancer is often made late, when treatment is less effective.

Healthcare provider and older adults discussing lung cancer

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While roughly half of lung cancers are diagnosed between the ages of 55 and 74, non-small cell lung cancer, in particular, may occur at any age; even in children. And while the overall incidence has been decreasing in recent years, the rate is actually increasing in young adults who have never smoked.

This article discusses how lung cancer affects different age groups.

Non-Small Cell Lung Cancer vs. Small Cell Lung Cancer

The two major types of lung cancer are:

  • Non-small cell lung cancer (NSCLC): This accounts for roughly 85% of tumors. NSCLC often grows in the outer regions of the lungs and may grow quite large before causing symptoms.
  • Small cell lung cancer (SCLC): This makes up 15% or less of tumors and is more strongly linked to smoking. Because it often grows near the large airways, SCLC tends to cause symptoms early.

Statistics

In 2021, it's estimated there were 235,760 new cases of lung cancer, with an estimated 131,880 deaths from the disease.

Once much more common in men, the rate has increased in women over the past few decades and now occurs at a rate of 60.1 cases/100,000 men and 47.9 cases/100,000 women. The median age at diagnosis is 71, with over 50% of these cancers occurring in people aged 55 to 74.

At What Age Can You Get Lung Cancer?
Age Group Percent of Lung Cancer Cases
 20 to 34  0.2%
 35 to 44  0.9%
 45 to 54  6.1%
 55 to 64  21.9%
 65 to 74  34.4%
 75 to 84  26.6%
Over 84 9.7%

Overall, the incidence of lung cancer has been decreasing, with a roughly 3.8% decrease in age-adjusted death rates each year between 2010 and 2019.

In contrast to this overall reduction in lung cancer, the incidence of the disease in young adults has been increasing in recent years. This is not thought to be simply a change in the proportion of people with lung cancer who smoked (as smoking decreases), but a true increase in incidence.

Lung cancer in young adults also differs in that it is more common in women than in men.

Lung Cancer in Young Adults

While lung cancer tends to occur in people more than 60 years old, it is not uncommon for people to be diagnosed as young adults, especially young women. In this age group, the disease is actually increasing.

Effects of Lung Cancer on People More Than 40 Years Old

People over 40 years old are more likely to have "typical" symptoms of lung cancer, and healthcare providers are more likely to consider the diagnosis than younger people.

That said, for those who have not smoked and do not have other risk factors, the possibility of lung cancer may not be immediately apparent. Roughly 10% to 20% of people who develop lung cancer have never smoked.

It's important to be aware of both the symptoms and the signs of lung cancer. Symptoms are feelings or sensations a person may notice themselves. Signs, or those findings, may be seen or pointed out by others.

Symptoms

Overall, the most common initial symptoms of lung cancer include:

  • A persistent cough. A cough due to lung cancer can be wet or dry, mild, or severe, and was found in 65% of people at the time of diagnosis in one study.
  • Chest pain.
  • Shortness of breath. Early on, shortness of breath may only occur with activity and may be dismissed as due to aging or inactivity.
  • Symptoms due to the spread of cancer to other regions of the body (metastases), such as back pain with bone metastases, headaches, visual changes, weakness with brain metastases, or nausea and abdominal pain with liver metastases.
  • Cancer fatigue. The fatigue associated with lung cancer may be severe, and not relieved by a good night of sleep or a cup of coffee.

Signs

The most common signs of lung cancer overall include:

  • Coughing up blood (hemoptysis). With hemoptysis, people often notice only a trace of blood or pink coloration on a tissue rather than frank blood. While coughing up blood is not the most common sign of lung cancer and can be due to other causes, it is the sign/symptom most strongly linked with a diagnosis.
  • Recurrent respiratory infections. Symptoms such as more than one episode of pneumonia in a year and others may occur when a tumor partially obstructs an airway.
  • Unintentional weight loss
  • Enlarged lymph nodes in the neck or in the area just above the collar bone (supraclavicular lymph nodes).
  • Signs of metastases, such as jaundice (a yellowish discoloration of the skin) with liver metastases, pathologic fractures or spinal cord compression (due to weakened bone from bone metastases), or seizures due to brain metastases.

Effects of Lung Cancer on People Less Than 40 Years Old

Lung cancer can behave differently and have different effects in people less than 40 years old for a few reasons.

In young adults, the proportion of never smokers is higher. In one study looking at 20 to 49-year-olds with lung cancer, 28% of the women and 18.6% of the men had never smoked.

The type of lung cancers often seen in never smokers (lung adenocarcinoma) tend to grow in the outer regions (periphery) of the lungs away from the large airways. For this reason, they are less likely to experience symptoms related to an airway obstruction such as a cough.

Lung cancer in young adults is often diagnosed later (more likely to be stage IV non-small cell lung cancer at diagnosis) than it is in older adults. This may lead to more symptoms related to the spread of cancer than due to its effect on the lungs.

Symptoms

Young people may experience all of the symptoms of lung cancer noted above, but the most common are shortness of breath and fatigue. These symptoms can be subtle at first, and are easily dismissed as being caused by another condition, or even lack of exercise.

Since tumors are, on average, diagnosed later than older adults, symptoms related to the spread of cancer to other regions of the body are also common, such as headaches due to brain metastases and back pain due to bone and/or adrenal metastases.

Signs

Signs of lung cancer, such as coughing up blood or recurrent respiratory infections are less common in young adults. Instead, signs related to the spread of cancer to other regions of the body may be the first sign.

This could include signs such as weakness or difficulty walking (due to other brain metastases or bone metastases in the spine), jaundice (a yellowish discoloration of the skin), or enlarged lymph nodes in the neck or above the collarbone.

When to Talk to Your Healthcare Provider

No matter your age and no matter your risk factors for lung cancer, it's important to talk to your healthcare provider if you experience any of the symptoms discussed above.

Some symptoms of lung cancer may not immediately make you (or your healthcare provider) think of lung cancer.

In retrospect, many people with lung cancer recall that they experienced symptoms for a significant period of time before the diagnosis was made. In one study, symptoms suggestive of lung cancer were present for 91 days on average before a diagnosis was made. With less typical symptoms, that increased to 117 days.

If You Used to Smoke

If you smoked in the past, and are age 50 or more, learn about lung cancer screening. Yearly low-dose CT screenings have been shown to save lives by detecting lung cancers at an early stage when treatment is most successful.

Summary

Lung cancer is most common between the ages of 54 and 75 but can occur at any age. An awareness of the signs and symptoms of the disease is important (along with lung cancer screening for those eligible) to catch the disease early, but these may vary depending on the age of diagnosis.

Older people are more likely to have symptoms typical of lung cancer such as a persistent cough or coughing up blood, whereas young people are more likely to have symptoms that are vague and subtle, such as severe fatigue and shortness of breath with activity.

A Word From Verywell

The importance of recognizing that lung cancer can occur at any age can't be understated.

Now it's become clear that younger adults not only develop lung cancer, but the incidence is rising. Along with raising awareness about breast cancer for young women, we need to remind people to look beneath the breasts as well and not dismiss the fact that anyone who has lungs can get lung cancer.

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