If you have never puffed on a cigarette in your life, you may think you won’t get lung cancer. And it’s true that the odds of avoiding lung cancer are in your favor—but some nonsmokers get it anyway. According to the American Cancer Society, as many as 20 percent of people in the United States who died from lung cancer in 2018—a total of roughly 30,000 people—never smoked.
A nonsmoker is a person who doesn’t currently smoke, but may have smoked 100 or so cigarettes at some point in their life. There are also people who are considered never-smokers, who have never smoked or who have smoked fewer than 100 cigarettes in their lifetimes. Smokers and non/never-smokers tend to develop different types of lung cancer; the latter group is more likely to develop lung cancer as a result of a genetic mutation or abnormality.
In the past five to 10 years, new knowledge about lung cancer has changed the way it is treated in both smokers and nonsmokers. “We used to think all lung cancers were the same, but now we understand that there are different kinds,” says Anne Chiang, MD, PhD, a Yale Medicine thoracic medical oncologist, and chief network officer and deputy chief medical officer for the Smilow Cancer Hospital and its Care Centers. “The good news is that the types of lung cancer that nonsmokers tend to get are usually driven by a molecular change or mutation that can be detected in the tumor, and there are drugs and therapeutics available for them. At Yale, we have a very active research program aimed at targeting those cancer cells that contain the mutation.”