Evaluating lung cancer risks and screening strategies for nonsmoking women

Lung cancer has been the leading cause of cancer-related deaths among women in the United States since 1987, with many cases diagnosed at advanced stages, despite screening methods like low-dose CT scans. Although smoking remains the primary risk factor for lung cancer, nonsmoking women, who make up 20% of lung cancer cases in the United States, are also at risk. However, there are no established guidelines for screening nonsmoking women, even as lung cancer rates rise in this group.

The study explores potential risk factors that may influence cancer staging and assesses the potential benefits of low-dose computed tomography (LDCT) screening for nonsmoking women.

This retrospective chart review analyzed 300 female patients diagnosed with lung cancer between 2019 and 2023. Data collected included smoking status, age, risk factors like family history, secondhand smoke, pulmonary comorbidities, cancer stage, and histology.

A logistic regression model found that pulmonary comorbidities, a history of another cancer, and smoking status significantly influenced the likelihood of being diagnosed with advanced-stage (III or IV) lung cancer. Nonsmoking women with history of a lung comorbidity or history of cancer were more likely to be diagnosed at an earlier stage (I or II).

The study suggests that lung cancer screening (with LDCT) could enhance early detection and staging in high-risk nonsmoking women, especially those with pulmonary comorbidities or history of other cancers.

The results underscore the importance of expanding lung cancer screening criteria to include high-risk nonsmoking women, particularly those with pulmonary comorbidities or prior cancer history.