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Rising incidence in younger populations, especially women, increasingly presents as adenocarcinoma with specific genetic mutations linked to air pollution and second-hand tobacco smoke exposure. USPSTF LDCT guidance was updated in 2021 but still excludes non-smokers. Age-based screening could improve cost-effectiveness and detection while avoiding missed diagnoses, and only Taiwan has a national LDCT screening program for high-risk individuals.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/increasing-awareness-of-lung-cancer-in-non-smokers-and-never-smokers-editorial/346251/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/increasing-awareness-of-lung-cancer-in-non-smokers-and-never-smokers-editorial/346251.png","ImageObject",300,407,{"name":92,"@type":93},"Logic","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why can lung cancer diagnosis and outcomes be delayed in non-smokers?","Question",{"text":113,"@type":114},"Because assumptions that lung cancer is almost always linked to cigarette smoking can delay recognition, diagnosis, and subsequent treatment in non-smokers.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How do current USPSTF screening recommendations address lung cancer in non-smoking individuals?",{"text":118,"@type":114},"The USPSTF updated its 2013 LDCT screening guidelines in 2021, but it still does not recommend lung cancer screening for non-smoking individuals.",{"name":120,"@type":111,"acceptedAnswer":121},"Which factors are associated with lung cancer risk in non-smokers and never-smokers?",{"text":122,"@type":114},"Risk factors include exposure to second-hand tobacco smoke, radon, air pollution, asbestos, and genetic factors, with non-smokers often presenting adenocarcinoma with specific genetic mutations.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},346251,1790096155,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52},1099513958762,"https://ap-avatar.wpscdn.com/avatar/1000023916a998db790?x-image-process=image/resize,m_fixed,w_180,h_180&k=1784791008015729253","EDITORIAL  \ne-ISSN 1643-3750  \n© Med Sci Monit, 2026; 32: e952454 DOI: 10. 12659/MSM.952454  \nReceived: 2025.12.16  \nAccepted: 2025.12.16  \nAvailable online: 2025.12.17  \nPublished: 2026.01.01  \nConflict of interest:  \nEditorial: Increasing Awareness of Lung Cancer in Non-Smokers and Never-Smokers Challenges Current Approaches to Prevention and Screening  \nDinah V. Parums, MD PhD   \nScience Editor, Medical Science Monitor, International Scientific Information, Inc., Melville, NY, USA e-mail:  \nNone declared  \n\n| Abstract | Lung cancer in never-smokers and in non-smokers accounts for between 15% and 25% of all lung cancers. Assumptions that lung cancer is almost always associated with cigarette smoking may delay diagnosis, treatment, and outcomes in non-smokers. The incidence of lung cancer in non-smokers is rising, especially in younger populations, presenting as adenocarcinoma with specific genetic mutations, and is associated with factors including air pollution and inhalation of second-hand tobacco smoke. In 2021, the United States Preventive Services Task Force (USPSTF) updated its 2013 lung cancer screening guidelines for low-dose computed tomography (LDCT) screening. However, the USPSTF still does not currently recommend lung cancer screening for non-smoking individuals. Therefore, age-based screening could improve cost-effectiveness and detection of lung cancer without missing diagnoses in women and never-smokers. Currently, only Taiwan has a national lung cancer screening program for early detection using LDCT in high-risk individuals. This editorial aims to highlight that non-smokers have risk factors for lung cancer that may challenge current criteria for inclusion in screening programs. |\n| --- | --- |\n| Keywords: | Lung Cancer • Screening • Smokers • Non-Smokers • Editorial |\n\nSince the 1950s, tobacco smoking has been recognized asthe most significant risk factor for lung cancer [1]. However, lung cancer can be caused by exposure to second-hand tobacco smoke, radon, air pollution, asbestos, and genetic factors [2]. In the US, between 10% and 20% of cases of lung cancer each year (or 20,000 to 40,000 cases) are diagnosed in people who never smoked or who smoked \u003C100 cigarettes in their lifetime [2]. In 2025, lung cancer remains the most common cancer worldwide, with some decline in the incidence in men but rising rates in younger women, possibly due to changes in patterns of cigarette smoking, domestic pollution, and air pollution [3]. Recent projections for lung cancer in the US are estimated to be 226,650 new cases and 124,730 deaths from lung cancer [2,4]. A non-smoker, or never-smoker, has smoked \u003C100 cigarettes in their lifetime, while a never-smoker has smoked ≥ 100 cigarettes in their lifetime, regardless of status [2]. Lung cancer in never-smokers and in non-smokers (who have smoked \u003C100 cigarettes in their lifetime) accounts for between 15% and 25% of all lung cancers [5].  \nIn a recent review of the literature, Murphy and colleagues have highlighted that assumptions that lung cancer is almost always associated with cigarette smoking may delay diagnosis, treatment, and outcomes in non-smokers [6]. The literature indicates that most lung cancers in nonsmoking individuals are non-small cell lung cancers (NSCLC), including adenocarcinomas  \n(60-80%) and squamous cell carcinomas (10-20%), and that small cell lung cancers are rare (\u003C10%) (Table 1) [6]. In the US, lung cancer in non-smokers currently accounts for between 15-20% of cases and is estimated to have an annual incidence of 14-21 per 100,000 for women and 5-14 per 100,000 for men [6]. Second-hand tobacco smoke, or environmental tobacco smoke, or passive smoke, is the combination of smoke from burning tobacco and exhaled smoke [7]. Second-hand smoke contains more than 60 chemical carcinogens, including benzene, arsenic, chromium, beryllium, and formaldehyde [7]. Epidemiology and disease database studies have shown that, as second-hand smoke exposure has ","cbCaiptkkWkVSHRG","https://ap.wps.com/l/cbCaiptkkWkVSHRG","pdf",253725,"English","# Editorial\n## Increasing Awareness and Prevention\n## Screening Guidelines and Gaps\n## Risk Factors and Epidemiology","[{\"question\":\"Why can lung cancer diagnosis and outcomes be delayed in non-smokers?\",\"answer\":\"Because assumptions that lung cancer is almost always linked to cigarette smoking can delay recognition, diagnosis, and subsequent treatment in non-smokers.\"},{\"question\":\"How do current USPSTF screening recommendations address lung cancer in non-smoking individuals?\",\"answer\":\"The USPSTF updated its 2013 LDCT screening guidelines in 2021, but it still does not recommend lung cancer screening for non-smoking individuals.\"},{\"question\":\"Which factors are associated with lung cancer risk in non-smokers and never-smokers?\",\"answer\":\"Risk factors include exposure to second-hand tobacco smoke, radon, air pollution, asbestos, and genetic factors, with non-smokers often presenting adenocarcinoma with specific genetic mutations.\"}]","Increasing Awareness of Lung Cancer in Non-Smokers and Never-Smokers - Editorial | PDF",1790060653]