Urgent attention is being called to gaps in lung cancer screening guidelines as research shows significant risks for never-smokers in minority communities, especially Asian women. Despite never having smoked, many individuals remain at a surprisingly high risk for developing lung cancer, with Asian women identified as a group developing the disease at similar rates compared to those with established risk factors.
Leading the research, Dr. Elaine Shum and her team conducted the Female Asian Nonsmoker Screening Study (FANSS), testing 1,000 Asian women ages 40 to 74 who never smoked. Shockingly, the rate of lung cancer detected was even higher than among groups with a history of heavy smoking. “I believe we have demonstrated that Asian women with no smoking history is one such group, but other studies are certainly warranted to explore other populations with no smoking history,” Dr. Shum noted.
Lung cancer among never-smokers now represents the fifth leading cause of cancer deaths worldwide, yet screening guidelines in the United States target only those with current or past smoking habits. The study found that most cases among never-smokers are diagnosed at advanced, often incurable stages. All the cancers detected harbored distinct driver mutations, such as EGFR or HER2, underlining biological differences between cancers in smokers and never-smokers.
Expanding research into additional high-risk minority populations is essential, Dr. Shum emphasized. As incidence rises within these groups, there is a pressing need for new screening protocols focusing on early detection to offer hope for cure among those historically overlooked by current guidelines.
See: “Lung cancer screening guidance needed for certain never-smokers” (September 18, 2025)
