Lung Cancer in Never Smokers (LCINS): Development of a UK National Research Strategy

Overview

Journal BJC Rep

Publisher Nature Portfolio

Date 2024 Nov 8

PMID 39516402

Authors

Sam Khan

Nathaniel Hatton

Daniel Tough

Robert C Rintoul

Coral Pepper

Lynn Calman

Fiona McDonald

Clare Harris

Amelia Randle

Michelle C Turner

Ruth A Haley

Janette Rawlinson

Philip A J Crosbie

Frank McCaughan

Matthew Hatton

Affiliations

Soon will be listed here.

Abstract

Introduction: Lung cancer in never smokers (LCINS) accounts for 15% of lung cancers diagnosed in the UK, making it the 8th most common cancer. There are few robust studies specific to the LCINS population making data surrounding the incidence and mortality of LCINS incomplete, leaving many gaps in our understanding of the needs of this population.

Methods: To address a lack of research in this important area, the UK National Cancer Research Institute Lung Study Group (NCRI-LSG) undertook a national survey and hosted a research strategy day to define key research priorities. A wide cross section of stakeholders, including patient advocates, the charitable sector, basic and translational researchers, and multi-disciplinary healthcare professionals contributed highlighting their research priorities.

Results: One-hundred twenty-seven surveys were completed (52 by patients/patient advocates) prior to the strategy day. These identified themes for expert review presentations and subsequent workshop discussions at the national research strategy day, which registered 190 attendees (50 patients/patient advocates). The four key themes that emerged to form the basis of a research strategy for LCINS are (1) Raising awareness, (2) Risk assessment and early detection, (3) Disease biology, (4) Living with and beyond.

Conclusion: This paper summarises current evidence and important gaps in our knowledge related to LCINS. We present recommendations for a national research strategy aimed at improving outcomes for patients.

References

Lebrett M, Crosbie E, Smith M, Woodward E, Evans D, Crosbie P . Targeting lung cancer screening to individuals at greatest risk: the role of genetic factors. J Med Genet. 2021; 58(4):217-226. PMC: 8005792. DOI: 10.1136/jmedgenet-2020-107399. View

Walter F, Rubin G, Bankhead C, Morris H, Hall N, Mills K . Symptoms and other factors associated with time to diagnosis and stage of lung cancer: a prospective cohort study. Br J Cancer. 2015; 112 Suppl 1:S6-13. PMC: 4385970. DOI: 10.1038/bjc.2015.30. View

Clement-Duchene C, Stock S, Xu X, Chang E, Gomez S, West D . Survival among Never-Smokers with Lung Cancer in the Cancer Care Outcomes Research and Surveillance Study. Ann Am Thorac Soc. 2016; 13(1):58-66. PMC: 5461981. DOI: 10.1513/AnnalsATS.201504-241OC. View

Turner M, Krewski D, Pope 3rd C, Chen Y, Gapstur S, Thun M . Long-term ambient fine particulate matter air pollution and lung cancer in a large cohort of never-smokers. Am J Respir Crit Care Med. 2011; 184(12):1374-81. DOI: 10.1164/rccm.201106-1011OC. View

Nemesure B, Albano D, Nemesure A . Short- and long-term survival outcomes among never smokers who developed lung cancer. Cancer Epidemiol. 2021; 75:102042. DOI: 10.1016/j.canep.2021.102042. View

Van Os S, Syversen A, Whitaker K, Quaife S, Janes S, Jallow M . Lung cancer symptom appraisal, help-seeking and diagnosis - rapid systematic review of differences between patients with and without a smoking history. Psychooncology. 2021; 31(4):562-576. DOI: 10.1002/pon.5846. View

Aberle D, Adams A, Berg C, Black W, Clapp J, Fagerstrom R . Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365(5):395-409. PMC: 4356534. DOI: 10.1056/NEJMoa1102873. View

Varghese A, Zakowski M, Yu H, Won H, Riely G, Krug L . Small-cell lung cancers in patients who never smoked cigarettes. J Thorac Oncol. 2014; 9(6):892-6. PMC: 4199745. DOI: 10.1097/JTO.0000000000000142. View

Hamilton W, Peters T, Round A, Sharp D . What are the clinical features of lung cancer before the diagnosis is made? A population based case-control study. Thorax. 2005; 60(12):1059-65. PMC: 1747254. DOI: 10.1136/thx.2005.045880. View

10.

Antonia S, Villegas A, Daniel D, Vicente D, Murakami S, Hui R . Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer. N Engl J Med. 2017; 377(20):1919-1929. DOI: 10.1056/NEJMoa1709937. View

11.

Saito S, Espinoza-Mercado F, Liu H, Sata N, Cui X, Soukiasian H . Current status of research and treatment for non-small cell lung cancer in never-smoking females. Cancer Biol Ther. 2017; 18(6):359-368. PMC: 5536938. DOI: 10.1080/15384047.2017.1323580. View

12.

Bryant A, Cerfolio R . Differences in epidemiology, histology, and survival between cigarette smokers and never-smokers who develop non-small cell lung cancer. Chest. 2007; 132(1):185-92. DOI: 10.1378/chest.07-0442. View

13.

Boye M, Wang X, Srimuninnimit V, Kang J, Tsai C, Orlando M . First-Line Pemetrexed Plus Cisplatin Followed by Gefitinib Maintenance Therapy Versus Gefitinib Monotherapy in East Asian Never-Smoker Patients With Locally Advanced or Metastatic Nonsquamous Non-Small-cell Lung Cancer: Quality of Life Results From.... Clin Lung Cancer. 2016; 17(2):150-60. DOI: 10.1016/j.cllc.2015.12.004. View

14.

Casal-Mourino A, Ruano-Ravina A, Torres-Duran M, Parente-Lamelas I, Provencio-Pulla M, Castro-Anon O . Lung cancer survival in never-smokers and exposure to residential radon: Results of the LCRINS study. Cancer Lett. 2020; 487:21-26. DOI: 10.1016/j.canlet.2020.05.022. View

15.

Dias M, Linhas R, Campainha S, Conde S, Barroso A . Lung cancer in never-smokers - what are the differences?. Acta Oncol. 2017; 56(7):931-935. DOI: 10.1080/0284186X.2017.1287944. View

16.

Kennedy M, Cheyne L, Darby M, Plant P, Milton R, Robson J . Lung cancer stage-shift following a symptom awareness campaign. Thorax. 2018; 73(12):1128-1136. DOI: 10.1136/thoraxjnl-2018-211842. View

17.

Bhopal A, Peake M, Gilligan D, Cosford P . Lung cancer in never-smokers: a hidden disease. J R Soc Med. 2019; 112(7):269-271. PMC: 6613278. DOI: 10.1177/0141076819843654. View

18.

Myers R, Brauer M, Dummer T, Atkar-Khattra S, Yee J, Melosky B . High-Ambient Air Pollution Exposure Among Never Smokers Versus Ever Smokers With Lung Cancer. J Thorac Oncol. 2021; 16(11):1850-1858. DOI: 10.1016/j.jtho.2021.06.015. View

19.

Cassim S, Chepulis L, Keenan R, Kidd J, Firth M, Lawrenson R . Patient and carer perceived barriers to early presentation and diagnosis of lung cancer: a systematic review. BMC Cancer. 2019; 19(1):25. PMC: 6323678. DOI: 10.1186/s12885-018-5169-9. View

20.

Cufari M, Proli C, De Sousa P, Raubenheimer H, Al Sahaf M, Chavan H . Increasing frequency of non-smoking lung cancer: Presentation of patients with early disease to a tertiary institution in the UK. Eur J Cancer. 2017; 84:55-59. DOI: 10.1016/j.ejca.2017.06.031. View