New Delhi: Lung cancer is increasingly being diagnosed in Indians who have never smoked, challenging the long-standing belief that the disease is mainly linked to tobacco use. Doctors are reporting cases among younger adults, including software professionals, endurance runners and homemakers, highlighting the possible role of air pollution, indoor smoke and genetic factors.
Recent data from leading Indian medical institutes suggest that 30% to 50% of newly diagnosed lung cancer cases in India may occur among “never-smokers”—people who have smoked fewer than 100 cigarettes in their lifetime. The trend has raised concerns about a wider public health problem, particularly in South Asia.
What is driving the rise?
Doctors and researchers point to several possible causes. PM2.5 air pollution, made up of extremely small particles that can travel deep into the lungs, is one major concern. Long-term exposure can cause inflammation and cellular damage, which may contribute to cancer development.
Indoor air pollution is another risk. In rural parts of India, many households still use wood, agricultural waste or animal dung for cooking. Burning these fuels in poorly ventilated kitchens produces smoke containing cancer-linked chemicals and can expose people, especially women, for years.
Other possible contributors include secondhand tobacco smoke, workplace pollutants and radon exposure. Research is continuing to determine how strongly each factor contributes to individual cases.
A different genetic profile
Non-smokers with lung cancer commonly develop adenocarcinoma, and their tumours may contain specific genetic changes such as EGFR or ALK mutations. These mutations can make some patients eligible for targeted treatments.
Why diagnosis is often delayed
Because lung cancer is still widely associated with smoking, non-smokers may not immediately consider it when they develop symptoms. A persistent cough, breathlessness or unexplained fatigue may instead be attributed to allergies, asthma or tuberculosis.
Doctors say persistent symptoms should be medically evaluated regardless of smoking history. For patients diagnosed with lung adenocarcinoma, molecular testing can help identify genetic changes that may guide treatment.
The growing number of cases among non-smokers is prompting a broader conversation about India’s air quality, indoor pollution and the need to recognise lung cancer as a disease that can affect people regardless of whether they smoke.
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