Lung cancer in non-smokers: causes and prognosis

What percentage of non-smoking men and women have lung cancer?

According to neurologists gathered in Lille for the 26th Congress of the Société de Pneumologie de Langue Française in January 2022, the proportion of non-smokers developing lung cancer has increased from 7.2% in 2000 to 12.6% today.

What are the causes of lung cancer in a non-smoker?

Smoking is the no. 1 avoidable risk factor: on its own, it is responsible for 8 out of 10 lung cancers according to The League Against Cancer. It is also possible to develop this disease being a passive smoker : in other words, the person has never been a smoker but has for years breathed the toxic smoke of people who smoke. “Of the 46,000 new cases a year, today in France, nearly 1,100 deaths are linked to passive smoking, including 150 from lung cancersays Pr. Norbert Ifrah, President of the National Cancer Institute (InCa). Tobacco smoke contains over 7,000 chemicals, 70 of which are known carcinogens“. But there are also other risk factors for the development of bronchopulmonary cancer:

• asbestos : according to’Health Insurance“the risk of developing lung cancer during exposure to asbestos is multiplied by 5 in the absence of tobacco consumption“
• THE radioactive substances (X and gamma rays, radon, etc.)
• There atmospheric pollution and diesel engine exhaust
• THE chronic bronchial and lung diseasess (COPD, tuberculosis, pulmonary emphysema, etc.)

What are the symptoms of lung cancer in a non-smoker?

“They are identical to those of lung cancer caused by smoking. Common symptoms combine breathing problems and an unexplained change in your general condition.“, explains Pr. Ifrah. It is about:

• tiredness
• weight loss
• A loss of appetite
• The appearance of a cough
• bloody sputum
• Breathing difficulties
• Recurrent lung infections
• Headaches

And more rarely:

• A change in the voice or its persistent extinction
• wheezing
• Difficulties swallowing
• Significant chest pain
• Edema of the face and neck
• Pain from neck to arm

What are the treatments for lung cancer in a non-smoker?

Treatments are similar to those for smoking-related lung cancers. They are based on the surgery, radiotherapy and drug treatments (conventional chemotherapy, targeted therapies, specific immunotherapies). These therapeutic solutions will be adapted to the evolution of the disease, its location, the patient’s state of health, etc. They can be used alone or in combination, depending on the case.

Non-smokers are healthier and better able to receive treatment

What is the prognosis for lung cancer in a non-smoker?

Considerable progress has been made in the treatment of lung cancer. Nevertheless, the 5-year survival prognosis remains poor. According to figures published by the National Cancer Institute and Public Health France in 2020: it is estimated at 20% for all sexes combined (respectively 24% for women and 18% for men). Life expectancy greatly depends on the type of cancer and the stage at diagnosis (extent of disease at diagnosis). While lung cancer remains the deadliest in France, its mortality rate between 1990 and 2018 decreased by 1.6% in men on average. On the other hand, it increased by 3% in women. “This is due to the increase in female smokingexplains Prof. Ifrah. Once lung cancer has appeared, it has not yet been demonstrated that its natural aggressiveness and its sensitivity to treatment are different in non-smokers. On the other hand, they are often in much better general condition than smokers, and better able to receive the treatments without reducing the theoretical doses“.

Thanks to Prof. Norbert Ifrah, President of the National Cancer Institute (InCa).

Sources:
– Tobacco is still the leading risk of cancer, 2020, La Ligue contre le Cancer
– Non-cancerous diseases and cancers due to asbestos, 2021, Assurance Maladie