TAMPA, Fla. — Most people think, when it comes to lung cancer, those who have it were smokers or around smokers. While that fact is not wrong, more and more people who have not smoked are getting the disease. 

What You Need To Know

  • A new European study published in the journal Radiology found lung nodules in more than one-fifth of nonsmokers

  • The study analyzed CT scans of more than 10,000 participants. It found at least one lung nodule in 42% of the participants

  • Currently, the U.S. Preventive Services Task Force does not recommend lung cancer screening for nonsmokers. Annual screening is recommended for adults ages 50 or older who have smoked a pack a day for the past 20 years or two packs a day for the past 10 years and currently smoke or have quit within the past 15 years

  • According to the National Institutes of Health, women who have never smoked are twice as likely to develop lung cancer than men who have never smoked

“This is my CT scan that I had in 2020, and you can see this fuzzy area up in the right side of my lung. That was the tumor when it was quite small,” said Maryann Stein, a lung cancer survivor. 

Stein never smoked, but was diagnosed with lung cancer after having a baseline and follow-up CT scan done. 

“I didn’t really expect to come back with a cancer diagnosis,” said Stein. “I was living my life and everything was great. And, it’s like, oh, wow. And lung cancer. This is really scary.”

Her cancer was detected early, and a surgery removed the small lung nodule and with it the cancer. 

But a lung cancer diagnosis like Stein’s is causing a bit of a stir.

“Here in the lung cancer community, we're really trying to de-stigmatize the role of smoking. And we do that by saying if you have lungs, you can get lung cancer," said Moffitt Cancer Center epidemiologist Matthew Schabath, PhD.

The Centers for Disease Control reports about 10 to 20 percent of lung cancer patients today were nonsmokers. 

Schabath said if “never smokers” with lung cancer are considered as a separate reportable disease, it would be the 11th leading cause of cancer in the U.S. and the 7th leading cause of cancer-related deaths.

“It’s on our radar. We just don’t know how to diagnose it early. And that’s the real challenge,” said Schabath. 

The problem is, if everyone gets a CT scan done to find lung nodules, more will certainly be found. However, Schabath points to a new European study that looked into this and found that less than two percent of those nodules would even be worrisome enough to be checked for cancer. Even fewer would then come back with a cancer diagnosis. 

Schabath firmly feels giving everyone CT scans is not the solution.

“We need more research,” said Schabath. “We need to bring together consortia. We need to bring together cancer centers and universities really across the country, because we need large numbers to identify what we call biomarkers. These are sort of indicators or bookmarks of people who are at a high risk.”

Until then, people should follow current standards of adults ages 50 or older who have smoked a pack a day for the past 20 years or two packs a day for the past 10 years and currently smoke or have quit within the past 15 years.

An exposure to concerning elements may also be a reason to be checked. Being around radon, second-hand smoke or, in Stein’s case, she was exposed to asbestos. 

“If you can get a baseline CT scan, they may tell you to come back in a year. They may tell you to come back in five years. But if you have that baseline, anything subsequent can be compared to it,” said Stein. 

Schabath does point to artificial intelligence as a new way forward to analyze data to help narrow down who should be screened for lung cancer. 

The hope is AI can look for biomarkers or genetic indicators to see who should and should not be screened.