He never smoked? I could still be at risk of developing lung cancer, doctors warn

Lung cancer, the second most common cancer in the United States, is often associated with smoking, but even those who have never had a cigarette could be at risk of mortal disease.

While it is true that those who smoke face a much higher risk, up to 20% of lung cancers affect people who have never smoked or smoked less than 100 cigarettes in their life, according to the centers for the control and prevention of diseases in the United States (CDC).

Despite this, the US preventive services task force (USPSTF) does not recommend the detection of lung cancer for those who have never smoked, since the agency establishes that risks can exceed potential benefits.

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Most lung cancers are divided into two groups: non -small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), according to the American Cancer Society.

NSCLC, which covers about 80% to 85% of all lung cancers, includes adenocarcinoma (common in non -smokers), squamous cell carcinoma and large cell carcinoma.

The remaining lung cancers are classified as SCLC, a more aggressive guy that tends to spread faster and has a poorer forecast.

Mohamed Abazeed, MD, Ph. D., President of Radiation Oncology and Professor of the William N brand at the Faculty of Medicine of the Feinberg Medicine of the Northwestern University in Chicago, agrees that the proportion of lung cancers diagnosed in never smokers is increasing, particularly between women and patients of Asian ancestry.

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“While the general incidence is decreasing due to the reduction of smoking rates, the relative participation of ever smokers is growing and is reflected in clinical practice, where we diagnose increasingly patients without a traditional smoking history,” he told News Digital.

Dr. Lauren Nicola, exercise radiologist and medical director of Reveal DX in North Carolina, said she is also seeing an increase in the freshly diagnosed lung cancer rate in non -smokers, particularly among younger women and adults.

The main factor that increases the proportion of non -smokers among patients with lung cancer, according to beazeed, is the successful impulse to reduce tobacco consumption in the United States.

“Other factors include improvements in images and the broader use of computerized tomographs that have improved the detection of early tumors,” he said.

“It is estimated that approximately 8% of lung cancers are inherited or occur due to a genetic predisposition.”

“Evolution environmental factors may also be contributing to this change, with contaminants that potentially drive pulmonary inflammation, which in turn has been involved in the development of cancer.”

Modifiable risk factors

According to Abazeed, some of the greatest non -smoking risk factors for lung cancer include ambient air pollution and second -hand smoke.

Thoracic radiation exposure (high energy radiation in the chest area), along with occupational risks such as radon, asbestos and diesel escape, can also increase the risk.

Inflammation related to lifestyle, which is often related to bad diet and sedentary behavior, can also play a role, Nicola said.

“Some of these, such as the quality of the radon and air, can be addressed at home or politics,” said Abazeed.

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“Lifestyle interventions, such as exercise, diet and avoidance of interior pollutants, can play a modest protective role.”

Both doctors pointed out that former smokers, especially those who smoked more frequently and for longer periods, remain at high risk even decades after quitting smoking.

“The higher the number of years of package, the more the risk will be,” Nicola said. “The risk decreases with the time after quitting smoking, but never returns to the baseline of a never smoker.”

Genetic risk factors

Some people inherit an increased risk of developing lung cancer due to their DNA.

“It is estimated that approximately 8% of lung cancers are inherited or occur due to a genetic predisposition,” Newseed Digital News told News.

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“Hereditary predisposition is an active research area, particularly in younger patients or in those with strong family history.”

Having a first grade relative with lung cancer doubles the risk of developing the disease, even after controlling smoking exposure, according to Nicola.

“Up to 50% of all thorax CTs will detect at least one pulmonary nodule.”

“Cancers in non -smokers are most frequently associated with specific genetic mutations and genomic profiles,” he said. “This suggests that these malignant have a different underlying biology compared to tumors in smokers.”

Projections in question

Current United States detection guidelines require annual low -risk dose computarized tomographies based on age and smoking history, reiterated Abazeed.

The USPSTF recommends the detection of “adults from 50 to 80 years who have a 20 -year smoking history and currently smoke or have resigned in the last 15 years.”

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“There is a growing interest in expanding eligibility to include risk factors for not smoking,” said Abazeed. “The evidence is accumulating that the current guidelines of the entire population could change.”

There are some potential risks linked to the expansion of detection, experts say, including the potential for overdiagnosis and false positives.

“The problem with the detection of all for lung cancer is that up to 50% of all thorax CT will detect at least one pulmonary nodule,” Nicola said. “The vast majority of these nodules are benign, but a small percentage will turn out to be cancer.”

Based on the size of the nodule, the clinician may recommend monitoring or biopsy images.

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“New tools are being developed that can help us better characterize the risk of malignancy of a nodule, which will reduce the potential for damage associated with overdiagnosis in detection,” Nicola said.