Study Finds Lung Nodules in 1 in 5 Nonsmoking Participants
When Patricia Judson was diagnosed with lung cancer, she couldn’t get one thought out of her mind:
“My only risk factor was having lungs.”
Judson, a gynecologic oncologist, had a cough she couldn’t shake in the spring of 2023. A CT scan showed what doctors thought was an infection in her lung, but antibiotics didn’t alleviate the cough.
"My only risk factor was having lungs," Patrica Judson said when she was diagnosed with stage 1 lung cancer as a never smoker.
Her colleagues urged her to continue to follow up, and Judson underwent a bronchoscopy this summer where doctors examined the inside of her lungs and biopsied the suspicious finding.
Judson was diagnosed with stage 1 lung cancer.
"You go through all of the five stages of grief and disbelief,” Judson said. “How can this happen to someone like me? I am the healthiest person I know.”
Judson, a never smoker, is not alone. While smoking is the leading cause of lung cancer, the Centers for Disease Control and Prevention estimates 10% to 20% of lung cancers each year in the U.S. occur in people who have never smoked or smoked fewer than 100 cigarettes in their life.
According to the National Institutes of Health, women who have never smoked are twice as likely to develop lung cancer than men who have never smoked.
Other risk factors besides smoking include exposure to radon, secondhand smoke, history of chronic pulmonary disease, exposure to asbestos and air pollution. Lung cancer can also be caused by genetic mutations. About 10% to 20% of cases are caused by a mutation in the epidermal growth factor receptor, or EGFR.
A new study published in the journal Radiology found lung nodules in more than one-fifth of Northern European nonsmokers. The study analyzed CT scans of more than 10,000 participants and found at least one lung nodule in 42% of the participants (47.5% were men and 37.7% were women). Clinically relevant nodules, or those measuring at least 6 millimeters, were found in 11.1% of participants.
Matthew Schabath, PhD
“If never smokers with lung cancer were considered a separate reportable category, they would be the 11th most common cancer and the seventh leading cause of cancer-related deaths in the U.S.,” said Matthew Schabath, PhD, a researcher in the Cancer Epidemiology Department at Moffitt Cancer Center. “This clearly emphasizes the urgent need to identify those never smokers at the highest risk of this disease that could be triaged into a lung cancer screening program.”
Currently, the U.S. Preventive Services Task Force does not recommend lung cancer screening for nonsmokers. Annual screening is recommended for adults ages 50 or older who have smoked a pack a day for the past 20 years or two packs a day for the past 10 years and currently smoke or have quit within the past 15 years.
If lung cancer is caught early, the survival rate for patients is 60%, compared to around 7% if the disease has spread. A 2023 study found that the 20-year survival rate for those diagnosed with early stage lung cancer through annual screening was 81%.
Judson had surgery at Moffitt to remove her lung tumor in July. Now she is focused on promoting the importance of listening to your body and advocating for your health, as well as increasing awareness of lung cancer screening for those who qualify.
“Because my cancer was caught early, I won’t need more treatment, which is huge, especially knowing the mortality rate is so high,” Judson said.
