Facing an un-met need in lung cancer screening: The never smokers

• Published in: Critical reviews in oncology/hematology 2024-10, Vol.202, p.104436, Article 104436
• Main Authors: Arrieta, Oscar, Arroyo-Hernández, Marisol, Soberanis-Piña, Pamela Denisse, Viola, Lucia, Del Re, Marzia, Russo, Alessandro, de Miguel-Perez, Diego, Cardona, Andrés F., Rolfo, Christian
• Format: Article
• Language: English
• Subjects: Cancer early detection; Early Detection of Cancer - methods; Female; Humans; Low dose CT scan; Lung cancer screening; Lung neoplasm; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Lung Neoplasms - etiology; Male; Never smokers; Non-Smokers - statistics & numerical data; Risk Factors; Smoking - adverse effects; Smoking - epidemiology
• ISSN: 1040-8428; 1879-0461; 1879-0461
• DOI: 10.1016/j.critrevonc.2024.104436

Lung cancer (LC) is the leading cause of cancer-related deaths worldwide and the second most common cancer in both men and women. In addition to smoking, other risk factors, such as environmental tobacco smoke, air pollution, biomass combustion, radon gas, occupational exposure, lung disease, family history of cancer, geographic variability, and genetic factors, play an essential role in developing LC. Current screening guidelines and eligibility criteria have limited efficacy in identifying LC cases (50 %), as most screening programs primarily target subjects with a smoking history as the leading risk factor. Implementing LC screening programs in people who have never smoked (PNS) can significantly impact cancer-specific survival and early disease detection. However, the available evidence regarding the feasibility and effectiveness of such programs is limited. Therefore, further research on LC screening in PNS is warranted to determine the necessary techniques for accurately identifying individuals who should be included in screening programs. [Display omitted] •Depending on the geographic area, up to 45 % of lung cancer patients never smoked.•Implementing a lung cancer screening program benefits patients' survival.•The addition of non-smoking risk factors to the current screening criteria will increase detection rates.•Risk prediction models optimize screening and future evaluations.