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Updated: Jan 10, 2026
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Cigarette Smoke Exposure in Mice using a Whole-Body Inhalation System
Published on: October 22, 2020
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Risk Factors Associated With Incidence of Lung Cancer in Never-Smokers: A Systematic Review and Meta-Analysis
Sindhu Bhaarrati Naidu1, Allegra Wisking2, Akul Karoshi2
1Lungs for Living Research Centre, UCL Respiratory, University College London, London, United Kingdom.
JTO Clinical and Research Reports
|November 24, 2025
Summary
This study identified key risk factors for lung cancer in never-smokers, including female sex, rheumatoid arthritis, and pollution. These findings can help develop early detection tools for lung cancer in non-smokers.
Area of Science:
- Oncology
- Epidemiology
- Environmental Health
Background:
- Lung cancer is a leading global cause of cancer mortality.
- A significant proportion of lung cancer cases occur in individuals who have never smoked (LCINS).
- Current tools for predicting LCINS are limited, especially for populations outside East Asia.
Purpose of the Study:
- To summarize risk factors associated with LCINS.
- To quantify the risk of LCINS in different geographical regions.
- To inform the development of predictive tools for LCINS.
Main Methods:
- A systematic review and meta-analysis of studies published from 2017.
- Inclusion of 54 studies with multivariable analysis of 192 factors in 16 million never-smokers.
- Risk of bias assessed using the Newcastle-Ottawa Scale.
Main Results:
- Female sex, previous cancer, rheumatoid arthritis, passive smoking, PM10, and PM2.5 pollution were associated with LCINS.
- Family history of lung cancer was associated with LCINS in East Asian populations but not in Western populations.
- No studies were assessed as having a high risk of bias.
Conclusions:
- Key factors linked with LCINS include female sex, rheumatoid arthritis, and pollution.
- This study quantified the association of these factors through global meta-analyses.
- Findings may facilitate the development of earlier detection tools for LCINS.
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