390eP Low-dose CT screening for early lung cancer detection in high-risk Kazakh regions with deep learning support

Background: Young patients with non-small cell lung cancer (NSCLC) represent a distinct biological subgroup, frequently enriched with actionable oncogenic drivers.However, real-world survival data from Latin America are limited.We evaluated survival outcomes and prognostic factors in young versus older patients with NSCLC treated in Peru. Methods:We conducted a retrospective cohort study including patients with histologically confirmed NSCLC treated between 2018 and 2024 at a national reference cancer center.Patients were stratified by age at diagnosis (<45 vs 45 years).Overall survival (OS) was estimated using the Kaplan-Meier method.Multivariable Cox regression was performed adjusting for sex, ECOG performance status, smoking history, clinical stage, histology, molecular alterations and first-line treatment.Results: A total of 317 patients were included; 19.9% were younger than 45 years.The cohort was predominantly female (59.3%), never-smokers (85.5%) and had adenocarcinoma histology (95.6%).Advanced disease (stage III-IV) was present in 94.0% of cases.Actionable molecular alterations were identified in 69.4% of patients, most commonly EGFR mutations (48.3%).Younger patients showed a higher frequency of actionable mutations compared with older patients (70% vs 56%, p=0.038).After a median follow-up of 40.9 months, 92 deaths (29.0%) were recorded.In adjusted analysis, young age was not associated with worse OS (adjusted HR 1.32; 95% CI 0.79-2.21;p=0.29).Former smoking history was the only independent predictor of inferior OS (adjusted HR 2.38; p=0.018).Conclusions: Young age at NSCLC diagnosis was not associated with inferior survival.Despite advanced-stage presentation, younger patients exhibited a high prevalence of actionable oncogenic drivers, supporting routine comprehensive molecular profiling.These results provide robust regional evidence and reinforce the importance of precision oncology in underrepresented populations.