I’ve never smoked, so why do I have lung cancer?

According to Cancer Research, the overall incidence of lung cancer in the UK has fallen by 9 per cent since the early 1990s, while the number of cases in women has risen by a third (32 per cent). “Lung cancer is one of the most common cancers in the UK, so 20 per cent of that is still a huge problem,” said Prof Sanjay Popat, oncologist consultant at the Royal Marsden Hospital. “We see more lung cancer in people who have never smoked than pancreatic cancer.” (The risk of pancreatic cancer is about twice as high in smokers compared to those who have never smoked.)

While tobacco use is still the leading risk factor (linked to 72 percent of lung cancer cases in the UK), 25 percent of lung cancer cases worldwide occur in never-smokers, according to the World Health Organisation. Many of these patients are women age 50 and under, and they are often diagnosed at stage 4, when the cancer has already spread and cannot be cured.

“We see a lot more women with this type of lung cancer than men, and we’re not sure why,” says Popat. “Although we see a connection with air pollution.”

A recent study led by cancer research-funded scientists at University College London and the Francis Crick Institute showed for the first time that air pollution can cause cancer in non-smokers. Although tobacco use is still the main risk factor.

Alix Burnard, from Berkshire, was 28 and never smoked when she was diagnosed with stage 4 lung cancer. “It started in March 2021 with a cough and a month later I had painful, swollen lymph nodes in my neck,” she says.

“Then I contacted my doctor. After a few rounds of antibiotics I didn’t get better, so I had an x-ray. But my cancer didn’t look like cancer. It wasn’t until the end of May, when I was so breathless I couldn’t speak and had lost 10kg, that I was sent to hospital and diagnosed.”

“My old life stopped at cancer, in terms of my career, my health, and my hobbies,” she says. “It feels like there’s an element of unfairness; I have always tried to live well. I had my whole life ahead of me and cancer has changed all that. I lost my health and a lot of my identity.”

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