This week, Bobbi Conner talks with Dr. Mariam Alexander about lung cancer in never-smokers. Dr. Alexander is an Associate Professor of Medicine and a hematologist/oncologist at MUSC Hollings Cancer Center.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. In recent years, overall lung cancer incidence rates in the U.S. have continued to decline. However, there is a rising proportion of lung cancer diagnosis among nonsmokers and younger adults, especially younger women. Doctor Mariam Alexander is here to talk about the details. Doctor Alexander is an Associate Professor of Medicine and an oncologist specializing in lung cancer at MUSC Hollings Cancer Center. Doctor Alexander, tell us more about recent trends in the US concerning the diagnosis of lung cancer.
Dr. Alexander: So, lung cancer is still the leading cause of cancer death in the US and the second most commonly diagnosed cancer in both men and women. But the overall picture is, as you said, actually improving, with new cases falling for decades, largely because fewer people are smoking. We actually find more cancers are being caught early. And this shift took off after low dose CT screening was recommended in 2013. What we are finding is that people who never smoked are making a bigger proportion of the lung cancer patients we're seeing.
Conner: Tell us more about what is known concerning lung cancer diagnosis in individuals who never smoked.
Dr. Alexander: A never-smoker is someone who has smoked fewer than 100 cigarettes in their entire lifetime. So, we are finding that people who never smoked are making up a bigger proportion of lung cancer patients. 20 years ago, it was under 10%, but today it's closer to 20%. But in the broader U.S. population, the rate among never smokers have been steady. But the worrying exception is in young Asian and Hispanic women, where lung cancer rates have either held steady or gone up.
Conner: What risk factors might have caused the development of lung cancer in never- smokers?
Dr. Alexander: We find that this rise is a convergence of genetic susceptibility, environmental exposures such as radon, cooking fumes, indoor, outdoor air pollution, and all interacting on a biology that is dominated by this EGFR mutated lung cancer.
Conner: What can be done to diagnose lung cancer early for never-smokers?
Dr. Alexander: So, never-smokers are not currently recommended for screening, and neither are young women because in patients with low risk screening can cause more harm than benefit. The current research is moving towards risk-based screening that uses other factors other than smoking, such as family history, environmental exposures, genetics, and possibly AI and blood-based biomarkers to identify high risk, never- smokers who could benefit from the screening. So, the future really isn't about scanning everyone, but getting better at figuring out who is actually at risk.
Conner: Tell us more about radon as a risk factor for lung cancer.
Dr. Alexander: So, in terms of environmental exposures, we know about radon, which is an odorless radioactive gas that is coming from uranium in the soil. It is responsible for 10 to 15% of US lung cancer deaths. And you can actually test for this using radon test kits. And you can mitigate this by a venting pipe and fan system that pulls it out before it enters the home.
Conner: Doctor Alexander, thanks for talking with us about trends related to lung cancer.
Dr. Alexander: You're welcome Bobbi, thanks so much for having me.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
