Understanding lung cancer beyond smoking: It’s not just about cigarettes anymore

More and more non-smokers, particularly women, are being diagnosed with lung cancer. The increasing prevalence of lung cancer among non-smokers is raising alarms, especially in countries where air pollution and other environmental factors are believed to play a significant role. While smoking remains a major risk factor, lung cancer is increasingly being recognised as a complex disease with multiple causes.

A persistent cough or an unexplained weight loss may seem like minor issues, but when combined with chest pain or shortness of breath, they may signal something far more serious. Many people dismiss these symptoms, attributing them to a simple cold or stress, but they can be early warning signs of lung cancer, especially in non-smokers, says Dr Vivek Singh, Director, Respiratory and Sleep Medicine, Medanta, Gurugram. “Lung cancer in non-smokers is a growing concern, and it is important to  focus on the environmental, genetic, and occupational factors that contribute to its rise. Early detection is vital, as symptoms often mimic other less serious conditions," he adds.

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Dr Singh breaks down symptoms of lung cancer that often go unnoticed at the early stage

• Air pollution and secondhand smoke

In highly polluted cities, the link between air pollution and lung cancer is becoming clearer. Long-term exposure to high levels of particulate matter (PM2.5), industrial emissions, and vehicular smoke can lead to severe lung inflammation and oxidative stress, both of which increase the likelihood of cancer development. Secondhand smoke remains another persistent environmental risk. Despite policies to combat smoking in public spaces, many non-smokers still find themselves exposed to harmful carcinogens in shared environments.

• Genetic predisposition and family history

Genetics also play a crucial role in lung cancer development, especially among non-smokers. Research indicates that people with a family history of lung cancer have an increases risk, even without direct tobacco exposure. Specific genetic mutations, such as those found in the EGFR gene, are more common in non-smokers, especially women. These mutations not only increase cancer risk but also affect how tumors grow, leading to innovations in targeted therapies that have significantly improved survival rates.

• Occupational and lifestyle hazards

Weak occupational health regulations where workers are regularly exposed to harmful carcinogens like asbestos, arsenic, and diesel exhaust, increase the risk of lung cancer, particularly when combined with pre-existing conditions like chronic obstructive pulmonary disease (COPD). Additionally, certain lifestyle factors, such as poor diet and lack of antioxidants, may make the body more vulnerable to cancer-causing substances.

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