The incidence of non-small cell lung cancer (NSCLC) in never-smokers appears to be increasing independent of sex, stage, and race/ethnicity, according to a study published in the Journal of the National Cancer Institute.1

Approximately 10% to 15% of lung cancer cases in the United States occur in people who have never smoked tobacco; however, whether this rate is increasing is unclear. To examine whether the proportion of never-smokers developing lung cancer is increasing, researchers retrospectively analyzed data from 10,593 NSCLC cases and 1510 small cell lung cancer (SCLC) cases. 

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The investigators collected demographic information obtained from 1990 to 2013 from the registries of 3 diverse institutions: The University of Texas Southwestern Medical Center in Dallas, Parkland Hospital in Dallas, and Vanderbilt University Medical Center in Nashville, Tennessee.

Results showed that the proportion of never-smokers who developed NSCLC increase from 8.0% during the period between 1990 and 1995 to 14.9% in 2011 to 2013 (P <.001). The investigators observed similar results after controlling for sex, stage at diagnosis, and race/ethnicity.

However, researchers found no statistically significant increase in the cases of SCLC (1.5% in 1990 to 1995 to 2.5% in 2011 to 2013; P =.36) or squamous cell NSCLC among never-smokers from the 1990 to 1995 period to the 2011 to 2013 period.

Given the findings that show that the number of NSCLC cases increased in never-smokers irrespective of sex, stage, and race/ethnicity, the authors conclude that the actual incidence of lung cancer in people who have smoked is increasing.


1. Pelosof L, Ahn C, Gao A, et al. Proportion of never-smoker non–small cell lung cancer patients at three diverse institutions. J Natl Cancer Inst. 2017 Jan 27. doi: 10.1093/jnci/djw295 [Epub ahead of print]