Lung cancer in people who have never smoked is under-recognised, rather than uncommon, say the authors of a commentary published in the Journal of the Royal Society of Medicine. They say lung cancer in never-smokers is more common than people think and is on the rise.
In the UK, it is estimated that nearly 6000 people who have never smoked die of lung cancer every year. The figure is higher than the numbers of people who die of cervical cancer (900), lymphoma (5200), leukaemia (4500) and ovarian cancer (4200).
While smoking remains the largest modifiable risk factor for lung cancer in the UK, accounting for 86 per cent of lung cancers, if considered as a separate entity, lung cancer in never-smokers is the eighth most common cause of cancer-related death in the UK and the seventh most prevalent cancer in the world.
Given the statistics, lung cancer in never-smokers needs to be given the recognition it deserves, say the authors - Anand Bhopal, Health Protection and Medical Directorate; Michael D Peake, University College London Hospitals Cancer Collaborative; David Gilligan, Addenbrooke’s Hospital; and Public Health England’s Paul Cosford.
In addition to promoting smoking cessation in the 15 per cent of UK who smoke, the authors advise that research priorities, health promotion material and frontline NHS services must reflect the needs of the wider lung cancer patient population.
They acknowledge that lung cancer in never-smokers does presents “a diagnostic challenge, particularly for general practitioners seeking to balance over-investigation with early diagnosis and high-quality care”.
They highlight a need for more sophisticated risk algorithms for use in primary care, which include the use of imaging and even biomarkers, to aide clinical decision-making.
