LUNG CANCER IN NEVER SMOKERS: AN ANALYSIS OF RISK FACTORS, CLINICAL PROFILES, AND THERAPEUTIC INNOVATIONS WITHIN A SOCIAL AND TECHNOLOGICAL FRAMEWORK
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5644Keywords:
Lung Cancer in Never Smokers, EGFR Mutations, Air Pollution, Medical Stigma, Artificial Intelligence in Oncology, Health PolicyAbstract
Lung cancer in never smokers (LCINS) is a clinically and biologically distinct disease- it is not simply a milder version of tobacco-related lung cancer. Every year, LCINS causes an estimated 200,000 deaths in the United States alone, making it more deadly than cancers of the cervix, ovary, or pancreas considered separately. Up to one in four people diagnosed with lung cancer has never smoked. This review examines why- tracing the environmental, genetic, and socioeconomic forces driving a disease that ranks among the top ten causes of cancer death worldwide. We conducted a systematic analysis of current literature focused on three main themes: the epidemiological shift in lung cancer, the molecular biology of LCINS- especially the EGFR and ALK pathways- and the psychosocial damage caused by the "smoker’s disease" label. Key findings show clear regional differences: in East Asia, never smokers make up over 50% of all lung cancer patients, driven by specific genetic vulnerabilities and environmental exposures such as cooking fumes and PM2.5 air pollution. The review also highlights the growing role of artificial intelligence in radiology and liquid biopsy for early detection- tools that could fundamentally change how we identify LCINS before it becomes incurable. A core finding is that current screening programs, designed around tobacco use, miss the majority of never-smoker patients. A shift to risk-based, technology-enhanced screening is urgently needed. Finally, this analysis argues that social science, specifically addressing stigma and health equity, must be integrated into clinical oncology if we want to improve outcomes globally.
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Copyright (c) 2026 Aleksandra Ustaszewska, Zofia Parol, Mateusz Żyła, Aleksandra Oszczypała, Aleksandra Potempa, Michał Petkow, Liwia Prorok, Katarzyna Lipska, Monika Szyszkowska, Zuzanna Strojek
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