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What Is Causing Lung Cancer in Never-smokers?

Lung cancer remains the most common cancer around the world. But as fewer people smoke and lung cancer rates decline, researchers are recognizing more lung cancer in nonsmokers. Between 10% and 20% of lung cancer diagnoses occur in people who have never smoked, according to a BBC article that explored ways these diagnoses differ from smoking-related cancer. Lung cancer not related to smoking is presenting as “a separate disease entity with distinct molecular characteristics that directly impact treatment decisions and outcomes,” Andreas Wicki, an oncologist at the University Hospital Zurich in Switzerland, told the BBC. For example, never-smokers are more likely than smokers to have cancer with certain genetic features, such as EGFR mutations, that can be treated with targeted medications. Lung cancer in never-smokers is also more common in women—especially in Asian women, who often are diagnosed with lung cancer that has an EGFR mutation. The article identifies studies that explore potential risk factors for the disease, including exposure to outdoor air pollution from fossil fuels. Lung cancer in never-smokers could become more prevalent as tobacco-related lung cancers continue to ebb, the article noted, which could challenge how society thinks about the disease. “The idea that they [patients] are at least partly to blame for their disease is unfortunately still widespread,” Wicki said.

(Learn more about air pollution and cancer risk in “Something in the Air: Pollution and Cancer,” in Cancer Today’s summer 2025 issue.)

Patients Benefit From Earlier Colonoscopy Screening

Research on screening colonoscopies offers evidence that adults between ages 45 and 49 are as likely to have abnormal findings on their colonoscopies as people between ages 50 and 54. The findings, published in JAMA, showed colonoscopy detected precursor lesions and cancer at similar rates for both age groups. For the study, researchers reviewed records from 12,031 patients who underwent a screening colonoscopy between 2021 and 2024 at Kaiser Permanente Northern California. They compared the results from 4,380 people who were 45 to 49 years old and 7,651 people who were 50 to 54 years old. The data support earlier findings that prompted the U.S. Preventive Services Task Force to lower the age recommendation for colonoscopy from 50 to 45 in 2021, Swati G. Patel, a gastroenterologist at University of Colorado Anschutz Medical Center in Denver, told Medscape. But people under 50 may not be following those recommendations. Researchers in a separate study estimated that only about one-third of eligible people between 45 and 49 have received any method of colorectal cancer screening, including colonoscopy. In comparison, 73% of eligible 50- to 75-year-olds have received recommended colorectal cancer screening, according to the article. “I think there’s a perception that it’s a cancer of older adults and that young healthy people don’t need to worry about it,” Patel told Medscape.

Alarming Rise in Appendix Cancer

A new study, published in Annals of Internal Medicine, shows that the number of appendix cancer cases is rising among people born after the 1970s. In fact, the incidence of appendix cancer has quadrupled for those born in the 1980s compared with those born in the 1940s. Appendix cancer is still considered rare—with an estimated 3,000 new cases in the U.S. each year, the New York Times reported. But the incremental increases in appendix cancer over generations suggest that common exposures, such as changes in the diet, could play a role in the development of the increase. Researchers have also observed similar generational effects in colorectal and gastric cancers, according to Andrew T. Chan, a gastroenterologist at Massachusetts General Hospital in Boston, who commented in the Times article. He said that the findings suggest these cancer types may have similar risk factors.