Non small cell lung cancer risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2] Maria Fernanda Villarreal, M.D. [3]

Overview

Common risk factors in the development of non small cell lung are smoking, family history of lung cancer, high levels of air pollution, radiation therapy to the chest, radon gas, asbestos, occupational exposure to chemical carcinogens, and previous lung disease.

Common Risk Factors

Common risk factors non-small cell lung cancer may include:[1][2]

Smoking

  • Cigarette smoking is the leading cause of non-small cell lung cancer.[3][4][5][6]
    • Both active and passive smoking are associated with increased risk of non-small cell lung cancer.
    • The risk of non-small cell lung cancer is associated with increased quantity of cigarette smoking as well as increased duration of smoking.
    • There is no evidence that smoking low-tar cigarettes lowers the risk.
    • There is a parallel correlation between the amount of cigarettes and the proportional risk of non-small cell lung cancer.
  • Recently introduced e-cigarettes, which were thought to be risk-free were recently demonstrated to be also associated with a significantly increased risk of non-small cell lung cancer due to the presence of formaldehyde.[7]
  • In the United States, smoking is estimated to account for 87% of non-small cell lung cancer cases (90% in men and 85% in women).[8]
  • There is approximately a 20 year lag period between smoking and death due to non-small cell lung cancer (in men).

Shown below is an image depicting the correlation between smoking and non-small cell lung cancer:

The incidence of lung cancer is highly correlated with smoking. Source: NIH


Second-hand smoke

Air Pollution

Family History of Lung Cancer

A positive family history of non-small cell lung cancer may increase the risk of non-small cell lung cancer.[1]

  • First-degree relatives of people who have had non-small cell lung cancer may have a slightly higher risk of developing non-small cell lung cancer themselves.
  • The increased risk among first-degree relatives could be due to a number of factors, such as shared behaviors or living in the same place where there are carcinogens.
  • Studies of families with a strong history of non-small cell lung cancer have found that the increased risk might be due to a mutation in a non-small cell lung cancer gene.
  • Other studies have shown that the risk of non-small cell lung cancer in a family increases if a family member developed the disease at an early age.

Radiation Therapy to the Chest

Positive history of radiation therapy to the chest increases the risk of non-small cell lung cancer due to the development of cellular damage and DNA mutations.[1]

Radon Exposure

Radon is a colorless, odorless, tasteless gas that comes from the natural breakdown of uranium in rocks and soil.[12]

  • Radon exposure increases the risk of non-small cell lung cancer.
  • Radon is the leading cause of non-small cell lung cancer in non-smokers and the second leading cause in smokers.

Asbestos Exposure

Exposure to asbestos fibers in the air increases the risk of non-small cell lung cancer.[12]

  • The risk of asbestos exposure is highest for people who work with asbestos, such as miners.
  • Studies have shown that the combination of smoking and asbestos exposure is especially hazardous.
  • Patients that are exposed to asbestos and smoke are at even greater risk of developing non-small cell lung cancer.

Exposure to Other Chemical Carcinogens

Other chemical carcinogens associated with small cell lung cancer include:[12]

Less Common Risk Factors

Less common risk factors non small cell lung cancer may include:[13][12]

References

  1. 1.0 1.1 1.2 Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA (2008). "Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship". Mayo Clin. Proc. 83 (5): 584–94. doi:10.4065/83.5.584. PMC 2718421. PMID 18452692.
  2. Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/risks/?region=ab#Outdoor_air_pollution Accessed February 3, 2016
  3. CDC (Dec 1986). "1986 Surgeon General's report: the health consequences of involuntary smoking". CDC. PMID 3097495. Retrieved 2007-08-10.
    * National Research Council (1986). Environmental tobacco smoke: measuring exposures and assessing health effects. National Academy Press. ISBN 0-309-07456-8.
    * Template:Cite paper
    * California Environmental Protection Agency (1997). "Health effects of exposure to environmental tobacco smoke". Tobacco Control. 6 (4): 346–353. PMID 9583639. Retrieved 2007-08-10.
    * CDC (Dec 2001). "State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke—United States, 2000". Morbidity and Mortality Weekly Report. CDC. 50 (49): 1101–1106. PMID 11794619. Retrieved 2007-08-10.
    * Alberg, AJ (Jan 2003). "Epidemiology of non-small cell lung cancer". Chest. American College of Chest Physicians. 123 (S1): 21S–49S. PMID 12527563. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  4. Boffetta, P (Oct 1998). "Multicenter case-control study of exposure to environmental tobacco smoke and non-small cell lung cancer in Europe". Journal of the National Cancer Institute. Oxford University Press. 90 (19): 1440–1450. PMID 9776409. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  5. "Report of the Scientific Committee on Tobacco and Health". Department of Health. Mar 1998. Retrieved 2007-07-09.
    * Hackshaw, AK (Jun 1998). "Lung cancer and passive smoking". Statistical Methods in Medical Research. 7 (2): 119–136. PMID 9654638.
  6. Template:Cite paper
  7. Jensen RP, Luo W, Pankow JF, Strongin RM, Peyton DH (2015). "Hidden formaldehyde in e-cigarette aerosols". N Engl J Med. 372 (4): 392–4. doi:10.1056/NEJMc1413069. PMID 25607446.
  8. Samet, JM (May 1988). "Cigarette smoking and non-small cell lung cancer in New Mexico". American Review of Respiratory Disease. 137 (5): 1110–1113. PMID 3264122. Unknown parameter |coauthors= ignored (help)
  9. 9.0 9.1 Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/risks/?region=ab#Outdoor_air_pollution
  10. Parent, ME (Jan 2007). "Exposure to diesel and gasoline engine emissions and the risk of non-small cell lung cancer". American Journal of Epidemiology. 165 (1): 53–62. PMID 17062632. Unknown parameter |coauthors= ignored (help)
  11. Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/risks/?region=ab#Outdoor_air_pollution
  12. 12.0 12.1 12.2 12.3 Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/risks/?region=ab#Outdoor_air_pollution
  13. "Non-Small Cell Lung Cancer Risk Factors".


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