Non-small cell lung cancer in never-smokers

Abstract

Introduction: In the past, lung cancer was assumed to be a tobacco related disease. Studies about lung cancer in never-smokers (NS) are still limited. Aim: To compare ever-smokers (ES) and NS with non-small cell lung cancer (NSCLC) regarding patient and tumor characteristics. Methods: Retrospective study of patients with NSCLC diagnosed in our Lung Cancer Unit over 5 years. Patients were split in two groups: NS ( Results: 563 patients included: 78% men, mean age 66±11years. 126 (22%) were NS with mean age 69±12 years, mostly women (75%) with adenocarcinoma (93%). Regarding tumor mutations, EGFR mutations were tested in 100 NS (35% EGFR+) and ALK translocation in 43 patients (25% ALK+). Univariate analysis showed that NS with lung cancer were more often women (75% vs. 7%, p Conclusion: The prevalence of NS among patients with lung cancer (22% in our study) should increase our awareness of these patients. Lung cancer in NS seems to be a different disease compared to ES. Patients were mainly women, probably due to genetic, hormonal or ambient factors besides tobacco. EGFR and ALK mutations were significantly more frequent in NS, with obvious implications in treatment. EGFR mutations differ between groups, which may suggest different carcinogenic pathways.