JAMA Clinical Reviews Lung Cancer in Nonsmoking Individuals
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Oct 20, 2025 Benjamin Solomon, PhD, a medical oncologist from the Peter MacCallum Cancer Centre, discusses the troubling rise of lung cancer in nonsmoking individuals, accounting for 15-20% of cases globally. He highlights the influence of environmental factors like air pollution and the peculiar histological differences, with adenocarcinoma being prevalent in nonsmokers. Solomon also tackles the lack of screening guidelines for this demographic, the challenges in early detection, and the importance of targeted therapies, emphasizing the need for better understanding and support for these patients.
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Significant Burden In Non-Smokers
- About 15 to 20% of global lung cancer cases occur in people who have smoked fewer than 100 cigarettes in their lifetime.
- If classified separately, lung cancer in non-smokers would rank as the seventh most common cancer worldwide.
Geographic And Sex Variation
- In the U.S. about 10% of men and 20% of women diagnosed with lung cancer report no smoking history.
- East Asian regions show higher proportions, with over 50% of women reporting no cigarette history in some areas.
Rising Proportion And Environmental Role
- The proportion of lung cancers in non-smokers is rising as smoking rates fall, although absolute case trends are less clear.
- Environmental risks like air pollution may be increasingly important contributors.