Frequency of Lung Cancer in Never-Smokers in the UK
In the United Kingdom, the frequency of lung cancer in never-smokers has doubled in the past 7 years, based on the study findings of Maria Elena Cufari, MBBS, of the Royal Brompton and Harefield NHS Foundation Trust, London, and colleagues. These results, published in the European Journal of Cancer, indicate presenting features were nonspecific, with the majority detected on incidental imaging.
Among a pool of 2170 patients with lung cancer, 436 patients (20%) were never-smokers. Presenting features were nonspecific and included cough (34%), chest infections (18%), and hemoptysis (11%). The mean age of patients was 60 years, and 67% were female. A total of 14% were detected on incidental chest film; 30%, on computed tomography; 7%, on positron-emission tomography/computed tomography; and 1%, on magnetic resonance imaging.
In a recent press release, the investigators noted: “There needs to be a paradigm shift in our thinking, as we often rationalize investigations based on the probability of disease. In this case, there are no identified risk factors to increase prior probability, and, consequently, the only way to increase detection is to lower the clinical threshold for investigating symptomatic never-smokers.”