{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:27:50Z","timestamp":1786512470301,"version":"build-2736575974"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The characteristics of early-onset lung cancer (EOLC) have not been extensively studied. Our research aimed to comprehensively assess the clinicopathological, genetic features and prognosis of EOLC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this retrospective study of lung cancer patients diagnosed at 26 Chongqing hospitals between January 2019 and December 2022 (18-74 years), we stratified them into early-onset lung cancer (&amp;lt;50 years) and late-onset lung cancer (\u226550 years) groups. Furthermore, we used propensity score matching to balance baseline characteristics, compare overall survival and lung cancer-specific survival between early-onset lung cancer (EOLC) and late-onset lung cancer (LOLC) groups, and perform subgroup comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 6,883 lung cancer patients were included in the final analysis, comprising 690 patients with EOLC and 6,193 patients with LOLC. Compared with the LOLC group, the EOLC group had more females and never-smokers. In clinical features, EOLC patients predominantly had adenocarcinoma (69.7% vs. 52.2%), more often presented with stage IV disease (49.3% vs. 44.0%), and had higher rates of bone (22.8% vs. 16.9%) and brain metastases (18.4% vs. 10.8%), yet were more likely to undergo surgery (31.0% vs. 22.4%). Significant differences in mutation rates were observed for HER2 (10.1% vs. 1.6%). After propensity score matching, late-onset was identified as an independent risk factor for adverse survival outcomes, the median overall survival was 42.7 months for EOLC versus 32.9 months for LOLC, with 1-, 3-, and 5-year survival rates of 78.0%, 54.4%, and 42.2% in the EOLC group, compared with 75.5%, 47.8%, and 35.4% in the LOLC group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite more aggressive clinicopathological features, EOLC was associated with better survival outcomes. Moreover, distinct driver gene alteration profiles highlight the need to identify targetable alterations and implement targeted therapy in this enriched population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1906257","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:39:30Z","timestamp":1786509570000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and survival in early-onset lung cancer: a multicenter cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Hongliang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Chongqing General Hospital & Chongqing Academy of Medical Sciences","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhikai","family":"Yu","sequence":"additional","affiliation":[{"name":"Office of Cancer Prevention and Control, Chongqing University Cancer Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Du","sequence":"additional","affiliation":[{"name":"Office of Cancer Prevention and Control, Chongqing University Cancer Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu","family":"Liu","sequence":"additional","affiliation":[{"name":"Office of Cancer Prevention and Control, Chongqing University Cancer Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Office of Cancer Prevention and Control, Chongqing University Cancer Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Guo","sequence":"additional","affiliation":[{"name":"Office of Cancer Prevention and Control, Chongqing University Cancer Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihong","family":"Mu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Research Center for Medicine and Social Development, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"He","sequence":"additional","affiliation":[{"name":"Office of Cancer Prevention and Control, Chongqing University Cancer Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00798-3","article-title":"The global burden of lung cancer: current status and future trends","volume":"20","author":"Leiter","year":"2023","journal-title":"Nat Rev Clin Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2218-6751.2015.08.04","article-title":"Global trends of lung cancer mortality and smoking prevalence","volume":"4","author":"Islami","year":"2015","journal-title":"Transl Lung Cancer Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1056\/NEJMoa1102873","article-title":"Reduced lung-cancer mortality with low-dose computed tomographic screening","volume":"365","author":"Aberle","year":"2011","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-022-00672-8","article-title":"Is early-onset cancer an emerging global epidemic? 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