Urgent Call for Action on Lung Cancer in People Who Have Never Smoked
Scientists have issued a stark warning that lung cancer in patients who have never smoked is on the rise, but it is often diagnosed at a later stage, leading to significantly poorer outcomes for those affected. This alarming trend highlights a critical gap in current healthcare strategies, which predominantly focus on smokers.
Global Impact and Statistics
In 2020, lung cancer in individuals who had never smoked emerged as the fifth most common cause of cancer death worldwide, ranking second only to tobacco-related lung cancer. According to Cancer Research UK, smoking remains the leading cause of premature and preventable death globally, responsible for more than a quarter of all cancer deaths in the UK. However, never-smokers constitute approximately 14 per cent of all lung cancer cases, a proportion that is growing as smoking rates decline.
Despite this, the overwhelming majority of lung cancer screening resources are directed towards smokers. In the UK, there is no routine lung cancer screening programme for people who have never smoked, creating a significant public health blind spot.
Research Findings and Recommendations
A comprehensive review by researchers at University College London (UCL), published in the journal Trends in Cancer, has called for urgent action to increase funding for screening and research into the causes of lung cancer in never-smokers. The review analysed evidence from studies involving several thousand lung cancer patients in the US and UK, revealing that cases in the UK doubled between 2008 and 2014.
Dr Rachel Orritt, health information manager at Cancer Research UK, explained to the Independent: "Most lung cancer cases are caused by smoking, but this paper helps to highlight this isn't always the case. Cell changes that can lead to cancer can happen at random in lung cells just as they can throughout the body."
Risk Factors Beyond Smoking
Dr Orritt detailed several key risk factors for lung cancer in never-smokers, including:
- Air pollution, particularly exposure to outdoor pollutants.
- Exposure to certain chemicals linked to industries, such as silica.
- Having a parent or sibling with a history of lung cancer.
- Living in areas with high levels of radon, a naturally occurring gas.
However, the relative risk associated with these factors is modest compared to smoking. For instance, smoking causes about 33,500 cases in the UK, while outdoor air pollution is linked to approximately 3,600 cases. This disparity makes screening for non-smoking risks more challenging to justify economically and logistically.
Challenges in Diagnosis and Screening
Study author Dr Deborah Caswell emphasised the need for a new strategy to detect lung cancer in never-smokers earlier. "If a young female non-smoker goes to her GP with shoulder pain, it may not even occur to the healthcare professional that lung cancer could be the cause," she said. This highlights how lung cancer in never-smokers is not currently viewed as a distinct type, complicating early interception.
Dr Caswell added: "Fewer people today are smoking, which is a good thing, but that has led to the proportion of lung cancer in never-smokers increasing, meaning we need better screening programmes and a better understanding of the causes."
Public Health Implications
The rise in lung cancer among never-smokers underscores the necessity for enhanced public awareness and healthcare adaptations. Dr Orritt advised: "We can't control everything that affects our risk of cancer, but if someone spots something that's not right for them, they should talk to their GP. It probably won't be cancer, but if it is, spotting it at an early stage can make all the difference."
As smoking rates continue to fall, the proportion of lung cancer cases in never-smokers is expected to grow, making it imperative to develop targeted screening methods and invest in research to identify underlying causes. This proactive approach could save lives by enabling earlier diagnosis and treatment for a demographic often overlooked in current cancer prevention efforts.
