Lung cancer cases rise among non-smokers

The disease is affecting an increasing number of women and young people who were not considered as high risk

Solange Vazquez

Friday, 19 May 2023, 12:22

The news that we have a tumour always comes as a tremendous blow. We suddenly find ourselves in a cloud of disbelief, especially if it is a type of cancer we never thought would affect us, but we are told it has.

Lung cancer, which is becoming increasingly prevalent, is one of them.

"This illness is affecting more women, more non-smokers and younger patients nowadays," warns Dr Margarita Majem, who is the vice-president of the Spanish association for research into lung cancer in women (ICAPEM).

Time is of the essence

The problem with this change of profile - lung cancer is being contained in men but cases among women have not stopped increasing for years - is that as the cases are unexpected they are detected later than they should be.

And, with all cancers, time is of the essence in tackling the disease and, in this particular case, is particularly essential.

The Data

30% of women who are diagnosed with lung cancer do not smoke. Cases among young people are also on the increase.

"It is important to warn people about this, to prevent them being diagnosed too late," says ICAPEM.

Why has there been this change in the profile of lung cancer patients, when until recently they were almost exclusively mature male smokers?

"The fact is that the health authorities have focused so much on persuading people to give up smoking and on checking smokers because of their enormous risk of getting lung cancer, that they have not paid as much attention to the causes of the illness. But after smoking, it appears that the principal risk comes from radon gas, air pollution, asbestos and even genetic causes which are currently being researched," the association says.

Also, if someone smokes and gets lung cancer, that is nearly always assumed to be the cause and other possibilities are not explored further.

Between 3% and 14% of lung cancer deaths are related to radon

Radon is second only to smoking as a cause of lung cancer, including in people who have never smoked a cigarette in their lives. And in smokers, the risk increases exponentially. "The World Health Organization estimates that between 3% and 14% of deaths from lung cancer are related to radon," warns Vivessinradon.org, a project developed by the Institute of Geoenvironmental Health. "The threshold below which exposure to radon does not pose a risk is unknown," says José Miguel Rodríguez, the head of the programme. Where is this radon? It is a carcinogenic gas which is produced naturally in the subsoil, especially in areas where there is granite (Galicia, Extremadura, parts of Madrid and Castilla y León), and it filters into the atmosphere through cracks in the ground. It normally dilutes in the air, but if it enters buildings due to porous materials or cracks in basements and foundations, it can concentrate and become a risk for people who live or work there. This is why measuresments need to be carried out. The Vivessinradon platform is calling for this to be done, and it also wants legal measures to protect the population to be implemented more rapidly.

Unpleasant surprises

The failure to look more deeply into causes other than smoking is leading to some unpleasant surprises. If a woman who does not smoke, or a young person, develops the first symptoms of lung cancer, it is possible that they will ignore them and not go to a doctor. And if they do go, the doctor may not be alarmed or order tests until it is serious and, on many occasions, by then it is too late.

The truth is that detecting lung cancer early in people who do not smoke is difficult, because the first signs of the illness can be confused with an ongoing infection, for example. These could be weight loss with no apparent cause, a persistent cough (sometimes with traces of blood), a feeling of constant fatigue, pain in the chest, a whistling sound when breathing... and that is why ICAPEM is calling for work on prevention, which focuses mainly on smokers, to be expanded. And the association's findings are backed up by the figures.

Lung cancer is now the third most common tumour among women in Spain, increasing by around four per cent a year, with almost the same increase in mortality. In fact, it is now the third cause of death among women in this country (it accounts for 12 per cent of total deaths from tumours).

It is estimated that last year between 8,500 and 9,000 women were diagnosed with lung cancer in this country.

The fact that cases are also increasing among young people - although lung cancer is still prevalent among mature adults - and women has given rise to a worrying reality:

"The numbers are still low but it is becoming more frequent for women who are diagnosed with lung cancer to be pregnant, and of course their condition means there are limitations on the treatment they can be given," say scientists at ICAPEM.