{"entity":{"id":"never-smoker-lung-cancer","kind":"term","name":"Lung cancer in never-smokers","aka":["lung cancer in never smokers","LCINS","never-smoker lung cancer","non-smoker lung cancer","lung cancer in people who have never smoked"],"tldr":"Lung cancer in someone who has never smoked. About 15 percent of UK lung cancers and 15 to 25 percent worldwide. It is usually adenocarcinoma, commoner in women, more likely to carry a mutation a drug can target, and invisible to every screening rule, because they all start from smoking history.","summary":"A never-smoker is conventionally someone who has smoked fewer than 100 cigarettes in their life. Lung cancer in never-smokers accounts for 15 percent of lung cancers diagnosed in the UK, which would make it the 8th commonest cancer in the country on its own (BJC Reports 2023), and 15 to 25 percent of lung cancers worldwide depending on region; counted as a separate disease it would be the 7th commonest cause of cancer death in the world (BMJ Open Respiratory Research 2026). It is a different disease from smoking-related lung cancer: overwhelmingly adenocarcinoma, commoner in women and in east Asian populations, with a low tumour mutational burden and a high rate of targetable drivers, particularly EGFR mutations and ALK fusions. The causes are only partly known. Cancer Research UK attributes 15 percent of never-smoker cases in the UK to second-hand smoke, which raises a never-smoker's risk by 31 percent; radon and outdoor air pollution account for more, and the IARC's own estimate put 114,486 male and 80,378 female adenocarcinomas worldwide in 2022 down to ambient particulate pollution. Beyond that the evidence thins: the UK Million Women Study followed 634,039 never-smoking women for 14 years, found 1,469 lung cancers and tested 34 candidate risk factors, of which only three were significant, non-white ethnicity (relative risk 2.34), asthma requiring treatment (1.32) and height of 165 cm or more (1.16). The practical consequences are that no screening programme currently offered would find these cancers early, and that the assumption a non-smoker's persistent cough is not cancer delays diagnosis; the UK's OLIVE cohort was set up in 2026 to study exactly this population.","asOf":"2026-09-25","wikipedia":"https://en.wikipedia.org/wiki/Lung_cancer","links":[{"label":"BJC Reports 2023: lung cancer in never smokers, development of a UK national research strategy (127 surveys, 190 attendees)","url":"https://doi.org/10.1038/s44276-023-00006-w"},{"label":"BMJ Open Respir Res 2026: observational study of predictors and outcomes of lung cancer in never-smokers in the UK (OLIVE), study protocol","url":"https://doi.org/10.1136/bmjresp-2025-003966"},{"label":"Pirie, Int J Cancer 2016: lung cancer in never smokers in the UK Million Women Study (634,039 never smokers, 1,469 lung cancers over 14 years)","url":"https://doi.org/10.1002/ijc.30084"},{"label":"Health Sci Rep 2026: lung cancer in never smokers, an underappreciated public health burden","url":"https://doi.org/10.1002/hsr2.73080"},{"label":"CRUK: lung cancer risk factors (attributable fractions for the UK)","url":"https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/risk-factors"},{"label":"Lancet Respir Med 2025: estimated worldwide variation and trends in incidence of lung cancer by histological subtype in 2022 and over time (GLOBOCAN 2022 with Cancer Incidence in Five Continents)","url":"https://doi.org/10.1016/s2213-2600(24)00428-4"}],"tags":["lung"],"related":[],"cancers":["lung-cancer","nsclc","lung-adenocarcinoma","egfr-mutant-nsclc","alk-positive-nsclc"],"sections":[],"technologies":["low-dose-ct-screening"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["pack-year","targeted-lung-health-check","radon","asbestos"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Epidemiology & prevention"},"route":"/terms/never-smoker-lung-cancer/","neighbours":{"cancer":[{"id":"lung-adenocarcinoma","kind":"cancer","name":"Adenocarcinoma of the lung","route":"/cancers/lung-adenocarcinoma/"},{"id":"alk-positive-nsclc","kind":"cancer","name":"ALK-positive non-small-cell lung cancer","route":"/cancers/alk-positive-nsclc/"},{"id":"egfr-mutant-nsclc","kind":"cancer","name":"EGFR-mutated non-small-cell lung cancer","route":"/cancers/egfr-mutant-nsclc/"},{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"technology":[{"id":"low-dose-ct-screening","kind":"technology","name":"Low-dose CT lung screening","route":"/technologies/low-dose-ct-screening/"}],"term":[{"id":"asbestos","kind":"term","name":"Asbestos","route":"/terms/asbestos/"},{"id":"pack-year","kind":"term","name":"Pack-year","route":"/terms/pack-year/"},{"id":"radon","kind":"term","name":"Radon","route":"/terms/radon/"},{"id":"smoking-cessation","kind":"term","name":"Stopping smoking","route":"/terms/smoking-cessation/"},{"id":"targeted-lung-health-check","kind":"term","name":"Targeted lung health check","route":"/terms/targeted-lung-health-check/"}],"biomarker":[{"id":"nrg1-fusion","kind":"biomarker","name":"NRG1 gene fusion","route":"/biomarkers/nrg1-fusion/"}]}}