Understanding That Not All Lung Cancer Cases Are Linked to Smoking

In recognition of Lung Cancer Awareness Month, observed each November, CURE spoke with Dr. Daniel J. Boffa, professor and division chief of Thoracic Surgery at Yale School of Medicine in New Haven, Connecticut.

In this conversation, Boffa discussed how public understanding of lung cancer is evolving beyond its long-standing association with smoking. He highlighted other significant risk factors for the disease and emphasized the importance of awareness and timely imaging for individuals who experience persistent respiratory issues, even if they have never smoked.

Transcript

Many people still associate lung cancer primarily with smoking. How is that perception changing, and what are some of the other risk factors or causes patients should be aware of?

Smoking is still the big story in lung cancer, as about 80 to 85% of patients who develop lung cancer will have smoked at one point in their lives. But one out of seven lung cancers happen in somebody who never smoked.

There's a variety of things that have been associated with cancer in never smokers. One of them is radon, which is an odorless gas that can seep into your home from the ground, so certainly when you're buying a new home, or if it hasn't been done in a while, it's important to test radon levels because there are ways of reducing those levels.

There are other environmental exposures, some that are less clear, but anything that irritates your throat and lungs when you're breathing is probably not a good thing. So, you want to minimize the time that you're working with chemicals in poorly ventilated areas. When there's wildfire smoke that's particularly thick, you could wear a mask or have a filter until the air clears.

The other category of lung cancer in never smokers can relate to genetics. There are some cancers that run-in families, but a lot of cancers that happen in people who never smoked, they are the first family member to have this. So, if you have a family member who never smoked and developed lung cancer, you do have a somewhat increased risk of lung cancer, and that's something to check in with your primary care provider about. There's no screening guidance for that group yet, but there probably will be in the next few years.

At the same time, even if you don't have a family member who developed lung cancer as someone who never smoked, and you’ve never smoked, if you develop a cough that doesn't go away after four weeks, or if you're coughing up blood, check in with your primary care provider, and you might need some imaging of your chest.

Transcript has been edited for clarity and conciseness.

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