Recognizing and preventing lung cancer for non-smokers

September 13, 2023 Providence Cancer Team


In this article:

  • Though most lung cancer deaths are linked to cigarette smoking, more and more lung cancer diagnoses are occurring among non-smokers.

  • Experts think lung cancer develops in non-smokers and never-smokers due to accumulated mutations in patients with possible genetic predispositions.

  • Early detection is tied to increased survival rates for lung cancer. Though there is currently no guidance for lung cancer screening for non-smokers, there are steps you can take to reduce your risk of developing lung cancer.

When it comes to lung cancer, there is much to be optimistic about: The rates of lung cancer diagnoses, especially among young men, have dropped significantly. While lung cancer remains the leading cause of cancer death in the U.S., the combination of reduced smoking, early cancer detection and improved cancer care and treatment options have vastly improved the outlook of this disease.

Unfortunately, while 90% of lung cancer deaths are tied to cigarette smoking, non-smokers are beginning to make up a larger proportion of lung cancer cases in the U.S. Understanding your risk factors can help prevent the development and spread of lung cancer, even for non-smokers.

How lung cancer develops

Researchers have found that most lung cancer tumors are caused by the accumulation of mutations – particularly in DNA repair genes. When environmental triggers like tobacco smoke, pollutants or other small particles get into the lungs, they can cause irritation that leads to mutations in healthy cells.

But mutations alone might not lead to cancer. Though there’s not been a single gene or biomarker identified, some oncology experts believe many lung cancer patients, especially non-smokers, may have a genetic predisposition that enhances the rate of mutations that lead to cancer.

“We don’t have one overarching explanation,” says Sid Devarakonda, M.D., director of thoracic medical oncology at the Providence Swedish Cancer Institute. “But it’s possible that a certain percentage of the diagnosed never-smoker population has a genetic predisposition.”

Risk factors for nonsmokers

Smoking status has historically been a leading cause of most lung cancer diagnoses, but secondhand smoke, pollution and exposure to other carcinogens can also lead to lung cancer – including among non-smokers.

Other risk factors for lung cancer among non-smokers include:

  • Family history of lung cancer
  • Increased age
  • Radiation, radon gas, asbestos and other carcinogen exposure
  • Secondhand smoke exposure

While lung cancer has traditionally impacted slightly more men than women, researchers have found that women diagnosed with lung cancer were far more likely to have never smoked than men diagnosed with lung cancer. This disparity was particularly high for Asian women.

Reducing your lung cancer risk

While lung cancer screening is recommended for many current and former smokers, the guidance is less clear for non-smokers. Lung cancer screening aims to catch cancer in an early stage before it spreads, which is often before any symptoms develop and when treatment can be most effective. Even if you are a non-smoker, speak with your physician if you have risk factors for lung cancer to determine if screening is right for you.

When it comes to cancer prevention, you can lower your risk of developing lung cancer by:

  • Avoiding secondhand smoke, air pollution and other carcinogens
  • Eating healthy foods
  • Maintaining an active lifestyle
  • Testing your home for radon, a naturally occurring, odorless gas

“Smoking is the most important and preventable cause of lung cancer,” says Dr. Devarakonda. “Anything that can cause inflammation through inhalation, or increase the risk of mutations in lung cells, in theory, could contribute to an increased risk of cancer.”

Contributing Caregiver

Sid Devarakonda, M.D., director of thoracic medical oncology at the Providence Swedish Cancer Institute

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Related resources

E-cigarettes (vaping) can be dangerous for your health

Celebrating and supporting cancer survivors

Breathe in, breathe out: Recognizing risk factors for lung cancer

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

About the Author

The Providence Cancer Team is committed to bringing you the most up-to-date insights about treatments, prevention, care and support available. We know cancer diagnoses strain you both mentally and physically, and we hope to provide a small piece of hope to you or your loved ones who are fighting the cancer battle with useful and clinically-backed advice.

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