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Medicine Science

Many Lung Cancers Are Now in Nonsmokers. Scientists Want to Know Why. (nytimes.com) 54

Roughly 10 to 25% of lung cancers worldwide now occur in people who have never smoked, according to researchers at the National Cancer Institute. Among certain groups of Asian and Asian American women, that share reaches 50% or more. Scientists studying 871 nonsmokers with lung cancer from around the world found that certain DNA mutations were significantly more common in people living in areas with high air pollution levels, including Hong Kong, Taiwan and Uzbekistan.

The research, published in Nature this month, revealed that pollution both directly damages DNA and causes cells to divide more rapidly. The biology of cancer in nonsmokers differs from smoking-related cases and may require different prevention and detection strategies. Nonsmokers with lung cancer are more likely to have specific "driver" mutations that can cause cancer, while smokers tend to accumulate many mutations over time.

Current U.S. screening guidelines recommend routine testing only for people ages 50 to 80 who smoked at least one pack daily for 20 years. Taiwan now offers screening for nonsmokers with family history after a nationwide trial detected cancer in 2.6% of participants.

Many Lung Cancers Are Now in Nonsmokers. Scientists Want to Know Why.

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  • I have known many smokers who died from old age (older than 90) rather than from any form of lung cancer.

    • I have known many smokers who died from old age (older than 90) rather than from any form of lung cancer.

      Smoking, and other risky behaviors, don't guarantee their respective terminal disease. They increase the likelihood of their associated terminal disease. Someone is going to get lucky, it'll just be the non-smoker more often due to lower risk. Smoking changes the odds, there is no guarantee either way.

      Someone makes it to 90, less likely the smoker.
      Someone dates the supermodel, less likely the overweight.
      Someone wins the lottery, less likely those who do not gamble -- wait, that didn't work out as inten

    • Thats good enough for me! Smoke em if you get em. Preferably unfiltered.
    • I have known many smokers who died from old age (older than 90) rather than from any form of lung cancer.

      If cancer doesn't get you, it'll be COPD. It's not even a roll of the dice, like cancer. It's accumulated damage. Both of my parents died from smoking related COPD. Leonard Nimoy died from COPD decades after quitting smoking.

      I can't believe that states are banning kratom because like 5 people OD'd on it, and 480,000 people in the US alone die every year from cigarettes. Smoking is bad.

    • by gweihir ( 88907 )

      Those that do not understand statistics will make many insightless statements about them ...

    • I also search for elephants with a magnifying glass and never find any.

    • by HBI ( 10338492 ) on Tuesday July 22, 2025 @01:22PM (#65537138)

      I knew a guy who lived to almost 94 who smoked virtually his whole life. Used to remember buying cigarettes in big round packages of 200 with paper tape around them. Born in 1897. Had a picture of him in WWI uniform. He died of bladder cancer. It was attributed to smoking. I don't know whether that is objectively true or not, but on the one hand living to 94 is just fine and him living another 10 or 15 years would have been less than appealing to me due to quality of life issues. He had bad cataracts, needed cornea transplants, no teeth and had a peptic ulcer that might have been curable in another 5-10 years, but highly constrained his diet and left him in pain a lot. But on the other hand he was a working carpenter until he was 6 months from death and went on hospice, and could do hand stands on barstools at 90+. Used to drive in 10 penny nails with a tiny tap to set and then whack, one shot into the wood. Weighed about 130 soaking wet.

      On the other hand I had a grandfather who died at 69 as a result of lung cancer. It was awful, wasted away from 180 to under 90 pounds in a relatively short time. Ironically he had quit smoking for about 20 years - from WWII through to the early 70s, but the heavy smoking during the war and later in life got him.

      His wife was a nonsmoker who died of lung cancer herself. But, she was a cocktail waitress who was around a lot of smoke, and lived next to a Maxwell House coffee plant. There's some kind of cancer cluster in that area, apparently breathing in coal dust and grounds isn't great for you.

      My stepfather had severe COPD and when associated with his leukemia, that helped take him out at 84. He had quit smoking about 20 years before his death, but it didn't save him from the symptoms.

      I quit in my 40s and had been off and on since my 20s. Hopefully I make out better than they did. I'm 56.

    • I have known many smokers who died from old age (older than 90) rather than from any form of lung cancer.

      True, but if you surveyed all 90-year-olds you would find a far smaller fraction who had smoked than the fraction of people born 90 years ago who smoked. Cancer is a statistical disease. It requires a certain number of random mutations in your DNA to activate and certain things, like smoking, increases the chances of those motations happening and thus increases your risk for cancer.

      In the same way that you can toss a coin 10 times and always get heads, you can smoke until you are 90 and not get cancer b

    • My brother-in-law just died from lung cancer that metastasized into bones, liver, brain, lymph nodes - pretty much saturated with it. Biopsies showed the cells to be lung cancer. He was 62, a life long heavy smoker, and died horribly. Don't spread bullshit. Cigarette smoking kills people, maybe not 1-to-1, but it does kill people.
      This is how corporations lied to Americans, and killed people for profit: https://www.youtube.com/watch?... [youtube.com]
    • As with most things, you are either susceptible or not. A lot of non smokers who got lung cancer probably got it from passive smoke from the unfiltered end.
  • Fewer Smokers (Score:5, Insightful)

    by nealric ( 3647765 ) on Tuesday July 22, 2025 @12:11PM (#65536880)

    It seems obvious that a decline in smoking would result in an increase of the percentage of lung cancers found in non-smokers. If nobody smoked, then 100% of lung cancers would be found in nonsmokers.

    • Re: (Score:3, Insightful)

      by Anonymous Coward

      It seems obvious

      The summary title should have read that scientists are now focusing on identifying other lung cancer sources.

    • Re:Fewer Smokers (Score:4, Insightful)

      by SouthSeb ( 8814349 ) on Tuesday July 22, 2025 @12:52PM (#65536998)

      That was exactly my first reaction to the summary. Less smokers equals proportionally more cases from other causes. Also, smoking never was the only cause of lung cancer, only the main risk factor.

    • I think the point of the article is to point out that now the rate of smoking has dropped considerably it is important that we start to look for other causes of lung cancer because these are now becoming increasingly important. This is research that has probably not been done before because, given the huge rate of the disease from smoking - including secondhand smoking - it would have been very hard to resolve other causes from the huge backgroiund rate due to smoking.
    • Re:Fewer Smokers (Score:5, Interesting)

      by dinfinity ( 2300094 ) on Tuesday July 22, 2025 @02:15PM (#65537302)

      Yep. It is a shit title, stupid spin and clear lack of understanding of the base rate (fallacy).

      "Roughly 10 to 25% of lung cancers worldwide now occur in people who have never smoked, according to researchers at the National Cancer Institute. Among certain groups of Asian and Asian American women, that share reaches 50% or more"

      This second sentence is completely uninteresting scientifically speaking, unless the base rate of smokers in that group is the same as that of other groups. It isn't, of course: women smoke much less than men and most Asian women even less (the base rates for some groups are as low as 2%).

    • From what I understand the studies take that into account. There's been a rise in the number of lung cancers that aren't related to smoking. I don't know what the cause is but there is definitely an increase.

      It could be all the plastic. We are absolutely filled with microplastic now. That's the most likely thing I think because it's the biggest change over the last 50 years.
      • Tire particulate. Only good thing because electric cars don't eliminate or even reduce smog. Most of that smog you see is tire particulate. We've been running zero emissions cars from most vehicles for a while now. We do have a problem with idling semi trucks but they mostly do that outside city limits. Most of the smog you're seeing is coming from little bits of tire.

        It's one of those things where scientists wondered for years were tires went because they aren't on the roads and it turns out the answer is

  • I miss smoking.... (Score:5, Insightful)

    by cayenne8 ( 626475 ) on Tuesday July 22, 2025 @12:13PM (#65536890) Homepage Journal
    ...it was fun...perfect thing to accompany a drink in the other hand.

    Something to do while talking to folks...

    Great excuse for a break, and when they made us go outside....it actually was a chance to hang with upper upper management quite often and get their ear when you otherwise would never see or meet them...that was always helpful in business.

    I'm a bit of a firebug too, so lighting them was always the best part.

    It also mean you always had a REAL lighter to hold up at concerts when cheering for encores....people holding phones up now...ugh.

    Too bad they can't some up with a healthy way to do it....but oh well, at this point in my life, I'd rather do what I can to extend what I have left....but man, I sure do miss it.

    • by Valgrus Thunderaxe ( 8769977 ) on Tuesday July 22, 2025 @12:21PM (#65536904)
      It's a disgusting habit and I don't miss it in the slightest. Even the smell of it or watching people smoke makes me sick.
      • by drnb ( 2434720 )

        It's a disgusting habit and I don't miss it in the slightest. Even the smell of it or watching people smoke makes me sick.

        Not a smoker, but I got the gene for the addiction. I always liked the smell.

    • by Tablizer ( 95088 )

      The brain pleasure triggered by nicotine has biased your view of the socializing. If you slap a meth addict in the face just when their high is kicking in, they'll start to view slapping favorably. The mental associating is strong.

    • It also mean you always had a REAL lighter ....

      It was a safety feature in the wilderness. You could always start a fire. Enjoy 3/4 of the smoke to relax despite being lost in the cold woods at night, use the remaining 1/4 as tinder to start a camp fire. Your pack of cigs and a zippo was an outdoor survival kit Try that with a vape, maybe you get one fire if you can pierce the battery with a rock. Smokes can keep you going for a weeks. :-)

      • It was a safety feature in the wilderness. You could always start a fire.

        So in the past people who filled their lungs with smoke could start fires in the wilderness. Today fires that start in the wilderness are filling people's lungs with smoke.

        • by drnb ( 2434720 )

          It was a safety feature in the wilderness. You could always start a fire.

          So in the past people who filled their lungs with smoke could start fires in the wilderness. Today fires that start in the wilderness are filling people's lungs with smoke.

          To be fair, the latter happened back then too. :-)

    • Great excuse for a break, and when they made us go outside....it actually was a chance to hang with upper upper management quite often and get their ear when you otherwise would never see or meet them...that was always helpful in business.

      Not so much the 'networking' for me as chatting to people in other departments and going outside. Smoking was an excuse to get far away from my desk and people who just "need a second".

      Too bad they can't some up with a healthy way to do it....but oh well, at this point in my life, I'd rather do what I can to extend what I have left....but man, I sure do miss it.

      There was a throwaway line in the game Prey (the second one) about the invention of cigarettes infused with nanoparticles that actually killed cancer cells in the lungs. Oh well, that would have been nice, smell notwithstanding.

  • varied over time. I suspect that's a major culprit.

    • varied over time. I suspect that's a major culprit.

      We also got rid of leaded gasoline, another known cancer risk.

      In general outdoor pollutants have dropped a lot thanks to the EPA.

      In short, the statistics 101 caveat: "all other things being equal", does not hold here.

    • do you have evidence indoor pollution has increased for everyone or most people?

    • Re: (Score:2, Insightful)

      by drinkypoo ( 153816 )

      So have outdoor pollutants. We keep inventing new additives for plastics and whatnot. We've also switched to using a lot of synthetic lubricants. All ICEs burn some oil, the cylinder walls get coated with some crankcase lube which is not wiped away by the rings during normal operation.

      I also think it's worth mentioning that modern houses are seriously toxic when they burn. The percentage of manufactured wood products has been increasing over time, as well as the plastic content. We used to use all copper pi

  • by backslashdot ( 95548 ) on Tuesday July 22, 2025 @12:38PM (#65536958)

    Science, Schmience! I rather have a talk show guy cherry-pick sources, void all context, and give me medical advice.

    • Science, Schmience! I rather have a talk show guy cherry-pick sources, void all context, and give me medical advice.

      Found the Stephen Colbert viewer. At least with the Limbaugh mention it was a reference to his Daily Show days back when he was funny. :-)

    • Science, Schmience! I rather have a talk show guy cherry-pick sources, void all context, and give me medical advice.

      Yeah, a dancing needles skit convinced me to get the COVID injection. :-)

  • Asian men continue to smoke like chimneys, second hand smoke during covid got the women?

     

  • The smokers died, now the people having lived with them die.

  • by aldousd666 ( 640240 ) on Tuesday July 22, 2025 @01:59PM (#65537256) Journal
    Ambient radiation, environmental pollution, random mutations, other carcinogenic mutagens... There can be like a bazillion reasons for getting cancer. Smoking is one we know about, and we know how it works pretty well. But like most cancers there's a big roll of the dice involved on top of literally countless other factors. This is not surprising even in the least.
    • Correct. Air pollution is definitely a defining factor. We still have many who grew up when air pollution from automobiles was still a serious issue, The long list of air pollutants from the exhaust of gasoline or diesel fueled engines can be quite long.

    • RADON. I think it was the #2 cause (not many breath in specific chemicals which would each get it's own classification and therefore not be close to radon.)
      It leaks into your house and you don't know it. It is random; it can go away at random as the random pockets of the gas seep up from the ground.

      Add to this the many forms of cancer some of which are so slow you'll die before it becomes a serious problem.

  • by SvnLyrBrto ( 62138 ) on Tuesday July 22, 2025 @02:33PM (#65537346)

    Fewer people smoke. So proportionally, more lung cancer victims will be non-smokers. No surprises there.

    But it's going to be decades until we see some real numbers and improvement. Because non-smokers don't live in a vacuum. Both of my parents smoked, my mother right up until the day she died. And both died from cancer. I never took up the habit, in no small part due to teenge rebellion against my parents. And to this day, it disgusts me. But also, I'm generation X. When I did move out of home, the dorms were non-smoking and when I got an apartment I only had non-smoking roommates. But in those days it was still socially acceptable (and legal) to smoke... on-campus but outdoors, in "non-smoking" sections of resturaunts, concerts, bars, raves, nightclubs, et cetera. I even tended bar in those days for a while.

    So, despite having never smoked a cigarrette in my life, I was around smokers for much of my first three decades. Hopefully the odds will be in my favor. But I'm pretty certain that I am at elevated risk for lung cancer. And no doctor or scientist worth his bones would be surprised. It is, as others have said, a numbers game.

    What we need is a few more decades... maybe a couple of generations... of smoking continuing to be socially intolerable. Once we have a good number of non-smokers, who were raised by and mostly social with non-smokers, who were raised by and mostly social with non-smokers; then we sould see some real numbers about the proper rate of lung cancer.

  • Both of my grandarents died from lung ailments.

    One of my grandfathers worked in factories his entire life, smoked for about 20 years of his youth, and and was generally of the socioeconomic level that wasn't able to live an extremely healthy lifestyle. He developed emphysema and associated conditions, and died in his low 70s. He had been on oxygen for years at that point.

    My other grandfather never smoked a day in his life, never drank, worked in academia, swam daily until sometime in his 80s, and died right

  • Smoking had a masking effect. In the past, if a person diagnosed with lung cancer ever so much as looked at a cigarette, that was the go-to for blame.

    Now that fewer people have ever smoked, they still get the lung cancer, only now there's nothing to blame it on.

    That's not to say that smoking doesn't increase the risk, just that that increase was never as great as it was made out to be.

  • This is something that has been discovered happening to people in clusters who live in the Midwest that are of non Asian descent.

    I am sure that a lot of the cause is from long term repeated exposures to VOCs, like NO2, from gas cooking/heating sources.

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