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. 1991 Aug;46(8):565–568. doi: 10.1136/thx.46.8.565

Lung cancer in lifelong non-smokers. Edinburgh Lung Cancer Group.

S Capewell 1, R Sankaran 1, D Lamb 1, M McIntyre 1, M F Sudlow 1
PMCID: PMC463274  PMID: 1656541

Abstract

The Edinburgh Lung Cancer Group registered 3070 new patients with lung cancer in the five years 1981-5 from a catchment population of 950,000. After review only 74 (2%) were classified as lifelong non-smokers. They differed significantly from the 2996 smokers with lung cancer in that far more were female (77% v 26%) and their mean age was higher (75.4 v 68.0 years). More were in the worst Karnofsky performance categories and fewer patients underwent surgery. The stages of disease were similarly distributed in the two groups and the five year survival was equally poor (5%). Histological cell type was determined in 59 of the 74 patients. All histological cell types were present. More non-smokers had adenocarcinoma than smokers (42% v 13%) and fewer had squamous cell carcinoma (32% v 49%) or small cell carcinoma (15% v 24%). Lung cancer in lifelong non-smokers is uncommon and the diagnosis should therefore always be questioned.

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Selected References

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  1. Ashley D. J., Davies H. D. Lung cancer in women. Thorax. 1969 Jul;24(4):446–450. doi: 10.1136/thx.24.4.446. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Auerbach O., Garfinkel L., Parks V. R. Histologic type of lung cancer in relation to smoking habits, year of diagnosis and sites of metastases. Chest. 1975 Apr;67(4):382–387. doi: 10.1378/chest.67.4.382. [DOI] [PubMed] [Google Scholar]
  3. Auerbach O., Garfinkel L., Parks V. R. Scar cancer of the lung: increase over a 21 year period. Cancer. 1979 Feb;43(2):636–642. doi: 10.1002/1097-0142(197902)43:2<636::aid-cncr2820430234>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  4. Beamis J. F., Jr, Stein A., Andrews J. L., Jr Changing epidemiology of lung cancer. Increasing incidence in women. Med Clin North Am. 1975 Mar;59(2):315–325. doi: 10.1016/s0025-7125(16)32034-x. [DOI] [PubMed] [Google Scholar]
  5. Belcher J. R. The changing pattern of bronchial carcinoma. Br J Dis Chest. 1975 Oct;69(0):247–258. doi: 10.1016/0007-0971(75)90093-5. [DOI] [PubMed] [Google Scholar]
  6. Capewell S., Sudlow M. F. Performance and prognosis in patients with lung cancer. The Edinburgh Lung Cancer Group. Thorax. 1990 Dec;45(12):951–956. doi: 10.1136/thx.45.12.951. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cooper D. A., Crane A. R., Boucot K. R. Primary carcinoma of the lung in nonsmokers. Arch Environ Health. 1968 Mar;16(3):398–400. doi: 10.1080/00039896.1968.10665077. [DOI] [PubMed] [Google Scholar]
  8. DOLL R., HILL A. B. Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950 Sep 30;2(4682):739–748. doi: 10.1136/bmj.2.4682.739. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Enstrom J. E. Rising lung cancer mortality among nonsmokers. J Natl Cancer Inst. 1979 Apr;62(4):755–760. [PubMed] [Google Scholar]
  11. Janerich D. T., Thompson W. D., Varela L. R., Greenwald P., Chorost S., Tucci C., Zaman M. B., Melamed M. R., Kiely M., McKneally M. F. Lung cancer and exposure to tobacco smoke in the household. N Engl J Med. 1990 Sep 6;323(10):632–636. doi: 10.1056/NEJM199009063231003. [DOI] [PubMed] [Google Scholar]
  12. Jindal S. K., Malik S. K., Datta B. N. Lung cancer in Northern India in relation to age, sex and smoking habits. Eur J Respir Dis. 1987 Jan;70(1):23–28. [PubMed] [Google Scholar]
  13. KREYBERG L. The significance of histological typing in the study of the epidemiology of primary epithelial lung tumours; a study of 466 cases. Br J Cancer. 1954 Jun;8(2):199–208. doi: 10.1038/bjc.1954.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Kabat G. C., Wynder E. L. Lung cancer in nonsmokers. Cancer. 1984 Mar 1;53(5):1214–1221. doi: 10.1002/1097-0142(19840301)53:5<1214::aid-cncr2820530532>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  15. Kennedy A. Relationship between cigarette smoking and histological type of lung cancer in women. Thorax. 1973 Mar;28(2):204–208. doi: 10.1136/thx.28.2.204. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Lamb D. Histological classification of lung cancer. Thorax. 1984 Mar;39(3):161–165. doi: 10.1136/thx.39.3.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lee P. N. Misclassification as a factor in passive smoking risk. Lancet. 1986 Oct 11;2(8511):867–867. doi: 10.1016/s0140-6736(86)92906-5. [DOI] [PubMed] [Google Scholar]
  18. Rylander R. Environmental tobacco smoke and lung cancer. Eur J Respir Dis Suppl. 1984;133:127–133. [PubMed] [Google Scholar]
  19. Vincent R. G., Pickren J. W., Lane W. W., Bross I., Takita H., Houten L., Gutierrez A. C., Rzepka T. The changing histopathology of lung cancer: a review of 1682 cases. Cancer. 1977 Apr;39(4):1647–1655. doi: 10.1002/1097-0142(197704)39:4<1647::aid-cncr2820390439>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  20. WYNDER E. L., GRAHAM E. A. Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma; a study of 684 proved cases. J Am Med Assoc. 1950 May 27;143(4):329–336. doi: 10.1001/jama.1950.02910390001001. [DOI] [PubMed] [Google Scholar]
  21. Wald N. J., Nanchahal K., Thompson S. G., Cuckle H. S. Does breathing other people's tobacco smoke cause lung cancer? Br Med J (Clin Res Ed) 1986 Nov 8;293(6556):1217–1222. doi: 10.1136/bmj.293.6556.1217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Weiss W., Boucot K. R., Seidman H., Carnahan W. J. Risk of lung cancer according to histologic type and cigarette dosage. JAMA. 1972 Nov 13;222(7):799–801. [PubMed] [Google Scholar]
  23. Wynder E. L., Berg J. W. Cancer of the lung among nonsmokers. Special reference to histologic patterns. Cancer. 1967 Jul;20(7):1161–1172. doi: 10.1002/1097-0142(196707)20:7<1161::aid-cncr2820200720>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  24. Wynder E. L., Goodman M. T. Smoking and lung cancer: some unresolved issues. Epidemiol Rev. 1983;5:177–207. doi: 10.1093/oxfordjournals.epirev.a036258. [DOI] [PubMed] [Google Scholar]
  25. Yesner R., Gelfman N. A., Feinstein A. R. A reappraisal of histopathology in lung cancer and correlation of cell types with antecedent cigarette smoking. Am Rev Respir Dis. 1973 May;107(5):790–797. doi: 10.1164/arrd.1973.107.5.790. [DOI] [PubMed] [Google Scholar]

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