C77-45 Beyond Tobacco: Lung Cancer in Young Non-Smokers and the Role of Environmental and Genetic Factors
Abstract
Lung cancer is commonly associated with older age and exposure to tobacco; recent evidence shows a small but significant increase among young adults (less than 54 years of age) who have never smoked. Recent case reports and epidemiological studies have highlighted changing patterns in histology, molecular biology, and environmental risk factors.
To summarise current evidence on the prevalence, clinical features and potential risk factors of lung cancer in young non-smokers (<54 years old).
We accessed databases including PubMed, MedLine, Embase, Cochrane, ProQuest and Prospero. We included English language studies and excluded studies which involved active and passive smoking. We looked at case reports, case series, single-centre reviews and epidemiological studies.
Twenty-one studies were identified that specifically looked at lung cancer in young non-smokers. Global data indicate that cases in individuals aged ≤ 54 years have increased by more than 50% since 1990, despite a decline in age-adjusted rates. Adenocarcinoma is the commonest histological pattern, often caused by molecular changes such as EGFR, ROS1, or ALK mutations. Environmental exposures, including cooking oil fumes, radon exposure and air pollution, are particularly prevalent among women, especially in low- to middle-income regions. Studies highlight histological subtypes like small cell, sarcomatoid, basaloid squamous, and micropapillary adenocarcinoma in young adults without tobacco exposure. Population…
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