Stanford Cancer Institute is reshaping lung cancer care by confronting a critical gap in screening guidelines that leaves many high-risk individuals undetected—especially Asian American women who have never smoked. While smoking remains the leading cause of lung cancer, a growing number of cases are emerging among non-smokers, and current screening criteria exclude them.
“We’ve really ramped up our screening program,” said Dr. Joseph Shrager, chief of thoracic surgery, “but right now, the guidelines and the payments from insurers are only for people with a certain amount of smoking history.” This exclusion disproportionately affects Asian women, who are more likely to develop lung cancer due to genetic mutations, not tobacco use.
Dr. Natalie Lui, a thoracic surgeon at Stanford, is raising funds for a screening trial focused on Asian women. Her work aims to expand early detection efforts and reshape national guidelines to include racial and genetic risk factors.
Shrager’s team is also investigating epidermal growth factor receptor (EGFR) mutations, which are common in non-smoking lung cancer patients. His lab is exploring CRISPR gene-editing technology to target these mutations. “Right now, we have targeted drugs that work pretty well,” Shrager said, “but [these patients] usually develop a resistance… CRISPR could be another alternative customizable to each mutation.”
These efforts reflect a broader push to transform lung cancer from a fatal diagnosis into a manageable condition—while addressing the racial and genetic disparities that have long been overlooked.
See: “Reshaping lung cancer outcomes” (November 5, 2024)
