Non-small cell lung cancer in never smokers as a representative 'non-smoking-associated lung cancer': Epidemiology and clinical features

Tokujiro Yano, Akira Haro, Yasunori Shikada, Riichiroh Maruyama, Yoshihiko Maehara

Research output: Contribution to journalReview article

68 Citations (Scopus)

Abstract

Recent interest in lung cancer without a history of tobacco smoking has led to the classification of a distinct disease entity of 'non-smoking-associated lung cancer'. In this review article, we have made an overview of the recent literature concerning both the epidemiology and clinical features of lung cancer in never smokers, and have brought 'non-smoking-associated lung cancer' into relief. The etiology of lung cancer in never smokers remains indefinite although many putative risk factors have been described including secondhand smoking, occupational exposures, pre-existing lung diseases, diet, estrogen exposure, etc. Non-small cell lung cancer (NSCLC) in never smokers is clinically characterized by an increased incidence in females and a higher occurrence of adenocarcinoma in comparison to NSCLC in ever smokers in both surgical patients and non-resectable advanced-stage patients. Furthermore, the prognosis of never-smoking NSCLC is better than that of smoking-related NSCLC in both surgical patients and non-resectable advanced-stage patients. Recently recognized novel gene mutations such as EGFR (epidermal growth factor receptor) mutations are largely limited to never smokers or light smokers, and the expression of this gene is responsible for the clinical efficacy of gefitinib, an epidermal growth factor receptor-tyrosine kinase inhibitor. NSCLC with the EML4 (echinoderm microtubule-associated protein-like 4)-ALK (anaplastic lymphoma kinase) fusion gene is also more likely to occur in never smokers and in those with adenocarcinoma histology, and is expected to benefit from ALK inhibitors. In consideration of the future increase in never-smoking NSCLC or 'non-smoking-associated lung cancer', both clinical trials and investigations are needed.

Original languageEnglish
Pages (from-to)287-293
Number of pages7
JournalInternational Journal of Clinical Oncology
Volume16
Issue number4
DOIs
Publication statusPublished - Aug 1 2011

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Non-Small Cell Lung Carcinoma
Lung Neoplasms
Epidemiology
Smoking
Epidermal Growth Factor Receptor
Adenocarcinoma
Tobacco Smoke Pollution
Mutation
Preexisting Condition Coverage
Gene Fusion
Occupational Exposure
Protein-Tyrosine Kinases
Lung Diseases
Histology
Estrogens
Clinical Trials
Diet
Gene Expression
Incidence
Genes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

Cite this

Non-small cell lung cancer in never smokers as a representative 'non-smoking-associated lung cancer' : Epidemiology and clinical features. / Yano, Tokujiro; Haro, Akira; Shikada, Yasunori; Maruyama, Riichiroh; Maehara, Yoshihiko.

In: International Journal of Clinical Oncology, Vol. 16, No. 4, 01.08.2011, p. 287-293.

Research output: Contribution to journalReview article

Yano, Tokujiro ; Haro, Akira ; Shikada, Yasunori ; Maruyama, Riichiroh ; Maehara, Yoshihiko. / Non-small cell lung cancer in never smokers as a representative 'non-smoking-associated lung cancer' : Epidemiology and clinical features. In: International Journal of Clinical Oncology. 2011 ; Vol. 16, No. 4. pp. 287-293.
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