Lung cancer predominantly affects the elderly. However, a small yet significant subgroup of patients below fifty years presents unique challenges in diagnosis and treatment. This study aims to describe the characteristics and outcomes of these young patients, emphasizing the need for improved diagnostic strategies and better prognostic outcomes. This national cohort study includes all patients diagnosed 2012-2023 recorded in the Danish Lung Cancer Registry. Patients below fifty years at diagnosis were categorized as young. Out of 57,325 patients a total of 1312 (2.3 %) were below fifty years at diagnosis. Young patients were more likely to be female (p = 0.006), diagnosed with adenocarcinoma (p < 0.001) and ten times more frequent anaplastic lymphoma kinase (ALK) mutated (p < 0.001). Young patients had fewer packyears (p < 0.001), better performance status (p < 0.001), lower Charlson Comorbidity index (p < 0.001), but were more frequently diagnosed in incurable disease stage, (68.0 % vs. 60.9 % p < 0.001). Adjusted OR of being diagnosed in a curable stage was 0.75 (95 %CI 0.66-0.85) for young patients, while adjusted OR for undergoing treatment with curative intent was 1.88 (1.58-2.23). Kaplan-Meier analysis indicated higher survival rates for young patients across all stages, but only marginally in stages IIIB-IV. Young patients diagnosed with lung cancer are less likely to be diagnosed in a curable stage. The pathology and smoking habits differ significantly from patients above fifty years. While pending screening is important for the older population of smokers, it remains essential to consistently address the need for early diagnosis in the young population to prevent exacerbating existing disparities.

Paediatric cancers are rare, yet, Italy has previously shown some of the highest incidence rates in Europe as a leading cause of death in children and adolescents. This study updates data from Italy for 2008-2017, analyses trends from 1998, and compares findings with other European regions. A population-based approach was used, leveraging data from the Italian Association of Cancer Registries (AIRTUM). Thirty-one cancer registries covering 77 % of the Italian paediatric population contributed data on tumour type, age, sex, residence, and diagnosis date. Cancers were classified using the International Classification of Childhood Cancer, Third Edition (ICCC-3). Age-specific (IR) and age-standardized incidence rates (ASR) were computed, while trends were analysed with Joinpoint regression to estimate annual (APC) and average annual percentage change (AAPC). From 2008-2017, 17,322 malignant paediatric cancer cases were reported in Italy. The age-standardized incidence rate (ASR) was 166.8 per million for ages 0-14 and 294.3 per million for adolescents 15-19. Over the study period, incidence rates were generally stable, but a significant increase was observed for bone tumours in children and thyroid and melanoma in adolescents. Central Italy showed higher incidence rates compared to other Italian regions. Italy still shows one of the highest incidence rates in Europe. While the study confirms overall stable incidence trends in Italy, it also highlights an increase in specific cancers such as melanoma and thyroid tumours in adolescents. Central Italy exhibited higher incidence rates, potentially due to environmental and/or diagnostic factors. Continuous monitoring and further research are needed to clarify regional variations and evaluate the impact of early diagnosis and environmental exposures.

Hungary is among the countries with the highest cancer mortality burden in Europe, consequently there is a crucial need to monitor changes in death rates in the population using appropriate surveillance tools. The Lexis diagram provides a means to depict age, period and cohort influences on long-term cancer mortality trends. Age-specific mortality rates for six cancer localizations were constructed based on the Deaths Register of the Hungarian Central Statistical Office and the Human Mortality Database, then smoothed (p-splines) within the cells of the Lexis diagram assuming Poisson distribution. After calculating the annual percentage change in mortality rates, the results were visualized using heat maps. Substantial reduction in mortality was observable from the mid-1990s in both sexes as a strong period effect, depicting two distinct epidemiological eras in Hungary. Since 2010, breast cancer mortality in women among ages 70-90 (those born between 1930 and 1950) has been rising. Women born between 1940 and 50 experienced two plateaus in lung cancer mortality, unlike men, emphasizing the delayed nature of the smoking epidemic. The results align with cancer transition patterns observed in similarly developed countries and emphasize a critical need to expand the implementation of effective primary and secondary prevention measures. This includes sustaining organized screening and anti-smoking programs, as well as introducing lung cancer screening with low-dose CT.