ArticleJournal of racial and ethnic health disparities2026
Stage-Survival Paradox in Young-Onset Lung Adenocarcinoma Patients Among Asian and Pacific Islander Women: A Population-Based Analysis.
Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLung adenocarcinoma (LUAD) in young adults may represent a distinct entity with sex and ancestry-related differences. Population-level data on incidence and survival remain limited. We assessed age- and stage-specific trends in early-onset LUAD and evaluated racial and sex disparities in presentation and outcomes.
methodsWe used the Surveillance, Epidemiology, and End Results (SEER) database to identify patients aged 15-49 years diagnosed with LUAD. Age-adjusted incidence and stage-specific trends were assessed using joinpoint regression. Cause-specific survival was analyzed using Kaplan-Meier methods and multivariable Cox regression, focusing on non-Hispanic Asian or Pacific Islander (NHAPI) females.
resultsAmong 14,109 patients, 1,149 (8.1%) were NHAPI females. Incidence trends were heterogeneous across groups, with relatively stable patterns in NHAPI females and variable trends in other populations. NHAPI females more frequently presented with distant-stage disease than non-Hispanic White patients (73.6% vs. 68.0%; p = 0.001). Despite this, they demonstrated superior survival. Five-year cause-specific survival was higher in NHAPI females, with a median survival of 38.0 versus 24.0 months in non-Hispanic White patients (log-rank p < 0.001). In multivariable analysis, non-Hispanic White patients had increased mortality risk compared with NHAPI females (HR 1.25, 95% CI 1.12-1.41). Stage remained the strongest prognostic factor, with higher risk in regional (HR 3.51) and distant disease (HR 12.41) versus localized disease (both p < 0.001).
conclusionsYoung NHAPI females represent a distinct LUAD subgroup characterized by a paradox of advanced-stage presentation but improved survival. These findings highlight clinically meaningful heterogeneity and support targeted strategies for early detection and prevention.
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