Jul 2026· International Journal of Environmental Health Research· pp.
1-12
· 0 citations· 21 references
Medicine
TL;DR
The results call for urgent public health measures (smoke-free home policies, indoor air pollution control) and long-term studies, multifactorial risk modelling, and evaluating interventions to reduce the global SHS-attributable lung cancer burden in this population.
Abstract
Lung cancer in never-smoking women is a growing global public health concern. Never-smokers account for approximately 25% of all lung cancer cases worldwide, with age-standardised incidence rates higher in never-smoking women than men. Household secondhand smoke (SHS) is a major preventable environmental risk factor, and chronic exposure is consistently associated with a 20-30% increase in lung cancer risk. The risk of lung cancer among never-smoking women related to SHS is multifactorial: carcinogen-induced DNA damage and oxidative stress, genetic susceptibility amplified by polygenic risk scores, reproductive and hormonal modifiers, co-exposure to indoor air pollutants from solid‑fuel combustion, as well as regional and sociodemographic disparities. The risk is greatest in countries with a high prevalence of male smoking, poor indoor ventilation, and limited enforcement of smoke-free policies, particularly in East and South Asia. Through a narrative review of 21 studies published before March 2026, the biological and epidemiological basis for SHS-associated lung cancer in never-smoking women is examined. The results call for urgent public health measures (smoke-free home policies, indoor air pollution control) and long-term studies, multifactorial risk modelling, and evaluating interventions to reduce the global SHS-attributable lung cancer burden in this population.
Smoking exposure, occupational hazards, unhealthy indoor environments, and chronic pulmonary diseases are important determinants of lung cancer in North Sumatra and public health strategies focusing on tobacco control, improved workplace safety, and reduction of indoor air pollution may substantially reduce lung cancer burden.
Putri Aulia Anwar, Noni Novisari Soeroso, Setia Putra Tarigan et al.· Experimental oncology· 0 citations
Smoking and solid fuel are common exposures among Chinese adults, yet evidence regarding their associations with cancer mortality remains inconsistent, and their joint effects are insufficiently studied. Using data from the Pengzhou site of the China Kadoorie Biobank in Sichuan Province, we applied Cox proportional hazards models to examine associations of smoking, cooking fuel use, and co-exposure with mortality from overall cancer and major site-specific cancers. Among 55,404 participants, 61.63% were women, 75.15% reported cooking, and 46.38% reported smoking; 2030 cancer deaths occurred during follow-up. Current smoking and solid fuel cooking were associated with 27% and 18% higher risks of overall cancer mortality. Initiation before 18 years increased overall cancer mortality by 37%, esophageal cancer mortality by 107%, and lung cancer mortality by 86%. Higher daily cigarette consumption, longer smoking duration, and greater cumulative smoking were each positively associated with mortality from overall cancer, esophageal cancer, and lung cancer. Compared with individuals who neither smoked nor used solid fuels, solid fuel use alone increased overall cancer mortality by 24%, while smoking alone increased overall mortality by 32% and esophageal cancer mortality by 144%. Individuals exposed to both smoking and solid fuel use had higher mortality risks, reaching 49% for overall cancer, 198% for esophageal cancer, and 94% for lung cancer. These findings highlight the critical importance of quitting smoking and promoting clean cooking fuels for cancer prevention.
Di Wu, Boke Chen, Xiao-Fang Chen et al.· International Journal of Can...· 0 citations
Introduction Tobacco exposure is a preventable breast cancer risk factor. High smoking rates among Vietnamese American (VA) men place VA women at elevated secondhand smoke exposure (SHSe) risk; yet research on the extent to which VA women are aware of SHSe and breast cancer risk is limited. Methods This community-partnered, mixed-methods, cross-sectional study examined SHSe prevalences, knowledge, attitudes, and beliefs about SHSe as a breast cancer risk factor among VA women (aged 18–65 years) and explored multilevel factors contributing to SHSe within VA families in Southern California, December 2024 – January 2026. We recruited self-identifying VA women (n=179) via a community-based, snowball strategy for a 30 min survey, and then conducted 60 min one-on-one interviews with 22 VA individuals (11 family dyads). Results Current SHSe prevalence was 43% (vs 25.2% nationally); 52.0% reported indoor SHSe during childhood. Only 63.7% had explicit home smoking rules, despite 99.4% believing SHSe affects children’s health and 85.2% linking SHSe to increased breast cancer risk. A Rapid Group Analysis Process of the interview data revealed 3 themes, corroborating survey findings: 1) Religious/spiritual influences led participants to attribute health outcomes to fate or divine will, undermining preventive behaviors and beliefs, 2) A lack of available health information contributed to uncertain/diverging views on breast cancer causes; and 3) Non-smoker women expressing challenges navigating familial smoking-related tension while maintaining relational harmony. Conclusions Our findings highlight the importance of family-centered communication while accounting for gender-related tension and family roles to promote cessation, breast cancer prevention and smoke-free spaces.
J. Huh, Vivian H. Tran, Artur Galimov et al.· Tobacco Prevention and Cessa...· 0 citations
BACKGROUND
Smokers are eligible for lung cancer screening using low dose CT (LDCT) if they have a sufficiently high risk of lung cancer. In England, for example, people are eligible if their estimated risk using either of two validated models (PLCOm2012 and Liverpool Lung Project) exceeds a certain threshold. Risk is often estimated using only cigarette consumption (duration and number per day), yet many smokers also use other cancer-causing tobacco products.
METHODS
SUMMIT is a prospective cohort study of a LDCT screening service. We evaluated the impact of cigars, pipes, and cigarillos on lung cancer risk.
RESULTS
Among 13,000 participants who were current/former cigarette smokers, 511 (1 in 25) were also regular users of cigars, pipes, or cigarillos. The 5-year cumulative lung cancer incidence in people who currently smoked both types of tobacco products was 8.85%, versus 5.74% for cigarette only current smokers. Among these 511 participants, the percentage whose risk was below the screening eligibility threshold ignoring other tobacco products which then exceeded the threshold including these products was 0.6% using LLPv2, and 8.2% using PLCOm2012.
CONCLUSIONS
All tobacco consumption should be considered when determining screening eligibility to avoid missing those who can benefit from LDCT.
CLINICAL TRIAL REGISTRATION
Clinicaltrials.gov no: NCT03934866.
S. Vaja, J. Dickson, Carolyn Horst et al.· British Journal of Cancer· 0 citations
Primary lung adenocarcinoma is the most common histological subtype of lung cancer. It disproportionately affects female sex, especially never-smokers. The rising incidence among females without a smoking history suggests roles for hormonal, genetic, and environmental factors. We conducted a comprehensive literature review using several databases. We examined global epidemiology data, molecular mechanisms, hormone-related pathways, and new diagnostic and therapeutic approaches. The findings show that estrogen signaling, especially via estrogen receptor beta (ERβ), contributes to oncogenesis. The mechanism involves cross-talk with
EGFR
and downstream MAPK/PI3K pathways.
EGFR
mutations appear more frequently in females. The association between KRAS and other cell cycle drivers is mixed across studies. Non-tobacco exposures, including air pollution and secondhand smoke, further increase risk among females. Diagnostic disparities persist because current screening guidelines focus on smoking. This approach excludes many high-risk never-smoking females. This review aims to narrate and synthesize growing evidence highlighting how female sex is associated with a distinct epidemiological footprint, unique molecular and biological profiles, and tailored therapeutic strategies in lung adenocarcinoma, driven by mechanisms beyond traditional tobacco exposure. Incorporating sex-specific risk assessment, hormonal level modification, and targeted gene therapies into clinical practice may improve screening and outcomes for females with lung adenocarcinoma.
M. Virata, Rizal Michael R. Abello, E. Brillante et al.· Oncology Reviews· 0 citations
BACKGROUND
Lung cancer is a leading contributor to global cancer incidence and mortality. While depression has been linked to adverse health behaviors, particularly tobacco smoking, that may elevate cancer risk, the direct relationship between depression and lung cancer remains uncertain. We aimed to clarify this association in a large cohort of Korean women.
METHODS
We analyzed data from the Korean National Health Information Database for women who completed the national health screening in 2012. A total of 2,032,241 participants aged 20 years or older were followed until December 2022. Depression was defined using insurance claims within the year preceding the baseline exam. Lung cancer cases were ascertained through matched health insurance and critical illness registration records. Adjusted hazard ratios (aHR) were calculated using multivariable Cox proportional hazards models.
RESULTS
Over a mean follow-up of 9.3 years, 11,706 women developed lung cancer. Those with depression experienced higher incidence rates (1.02 per 1,000 person-years) and a modestly increased risk (aHR 1.09, 95% confidence interval [CI] 1.02-1.16) compared with women without depression. Stratified analyses indicated stronger associations among women aged 40-64 years (aHR 1.13, 95% CI 1.04-1.24), and former smokers (aHR 2.33, 95% CI 1.66-3.28)-particularly former smokers with at least 20 pack-years of smoking exposure (aHR 4.93, 95% CI 2.55-9.51).
CONCLUSION
Depression was associated with elevated lung cancer risk in women, with effects modified by age and smoking history. Targeted interventions addressing mental health may contribute to lung cancer prevention, especially in susceptible subgroups.
C. Chung, Kyu Na Lee, Kyungdo Han et al.· Tuberculosis and Respiratory...· 0 citations
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