Complex Mix of Genetic and Environmental Risks
Lung Cancer in Never Smokers Needs a New Approach
18 Feb 2026 Respiratory View All News
LUNG cancer in never smokers is emerging as a major global health concern, with patterns that differ strikingly from smoking-related disease. This group often falls outside traditional high-risk criteria, meaning symptoms may be overlooked and many patients are diagnosed only once cancer has spread, when treatment is mainly palliative. In a recent opinion article, experts argue that lung cancer in never smokers requires a different approach to detection and prevention.
Lung cancer in never smokers tends to affect women and Asian populations more frequently and is usually an adenocarcinoma with so-called“ oncogene-addicted” tumours driven by mutations or fusions in genes such as EGFR and ALK. These cancers often carry multiple actionable driver mutations but a lower overall mutational burden, which helps explain why they respond well to tyrosine kinase inhibitors yet much less to standard immune checkpoint inhibitors.
Complex Mix of Genetic and Environmental Risks
The opinion article highlights a web of inherited and acquired risk factors rather than a single cause. Germline variants in oncogenes and DNA repair genes, APOBEC3A / B