Papers Look at Lung Cancer Factors in Never Smokers

Never smokers defined as those who have smoked fewer than 100 cigarettes in their lifetime
By Eric Metcalf
HealthDay Reporter

MONDAY, Sept. 21 (HealthDay News) -- A guide to lung cancer in never smokers offers an overview of the disease, a description of the epidemiology and risk factors for lung cancer in those who have never smoked, and differences in molecular profiles between this group and smokers, as published in three papers in the Sept. 15 Clinical Cancer Research.

In the epidemiology article, Jonathan M. Samet, M.D., of Johns Hopkins University in Baltimore, and colleagues write that 10 to 15 percent of lung cancers occur in never smokers, and the disease accounts for 16,000 to 24,000 deaths in this group annually in the United States. Evidence supports secondhand smoke and exposure to radon as causes of lung cancer in never smokers, and these may account for most cases. Other factors associated with the disease include asbestos, arsenic, and silica.

In the molecular profile article, Charles M. Rudin, M.D., also of Johns Hopkins University, and colleagues write that TP53, KRAS, and EGFR are among the tumor suppressor genes and proto-oncogenes that have different mutational profiles in lung cancers in never smokers and ever smokers. Several recent anti-cancer drugs target the epidermal growth factor receptor; researchers have found that lung cancer patients with minimal tobacco-use history have better outcomes with gefitinib and erlotinib treatment.

"The death rate due to lung cancer in never smokers over several decades has remained relatively constant in the United States, and represents a significant ongoing public health problem," Samet and colleagues conclude. "Given the significant impact of lung cancer in never smokers, focused research on genetic and environmental factors associated with this disease, in carefully defined and extensively characterized populations, is warranted."

The studies were supported by the Flight Attendant Medical Research Institute.

Abstract - Samet
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Abstract - Rudin
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Abstract - Overview
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