Geographic and demographic disparities in lung cancer prevalence among young adults: A SEER-based analysis.

e22552 Background: Lung cancer in young adults (<55 years) is rare but has gained attention as a special clinical entity. This population often presents with advanced-stage disease, unique genomic profiles and marked psychosocial difficulties. Environmental exposures, such as radon and outdoor air pollution, alongside traditional risk factors like tobacco use, may disproportionately affect this group. Understanding geographic disparities in prevalence may provide insight into developing targeted prevention approaches. Methods: Using SEER Program data (2000–2020), we analyzed lung cancer prevalence in individuals under 55 years as of January 1, 2020. Malignant lung and bronchus cancer cases across 17 registries were included. Crude prevalence percentages were calculated across U.S. states and counties to identify geographic patterns and hotspots. Results: Among 19,291 cases, geographic variability in prevalence was significant. Kentucky had the highest prevalence rate (0.06232%), followed by West Virginia and the Appalachian corridor. Counties like Pike County, KY, and Logan County, WV, demonstrated rates exceeding 0.05%. In contrast, states like California, New Jersey, and Colorado reported lower prevalence rates (<0.01%), particularly in urban areas. Rural regions bore a disproportionate burden, likely due to higher tobacco use, occupational exposures, and limited healthcare access. Age-stratified data revealed a peak in prevalence among individuals aged 50–54 years, with significantly lower rates in those under 35 years. A male-to-female ratio of 1.3:1 was observed, with males exhibiting higher prevalence across most regions. Socioeconomic disparities were evident, with lower-income counties demonstrating higher rates. Non-Hispanic Whites accounted for the majority of lung cancer cases in rural areas, while African Americans experienced a higher prevalence in urban counties, particularly in Georgia and Louisiana, underscoring significant racial disparities. Conclusions: Significant geographic and demographic disparities in lung cancer prevalence are present among young adults in the U.S. These findings underscore the need for targeted prevention and screening in high-burden regions and more research into modifiable risk factors and healthcare inequities to inform policy and clinical practice. Top 5 counties with highest lung cancer prevalence in young adults. State: County Prevalence (%) Prevalence Count Population KY: Leslie County 0.06522 9.0 13,800.0 KY: Wolfe County 0.06232 4.0 6,419.0 KY: Logan County 0.05687 14.8 26,084.0 KY: Livingston County 0.05397 3.0 5,558.5 LA: Ascension Parish 0.05093 4.0 7,854.5