Since November is National Lung Cancer Awareness month I have been trying to provide additional information on this serious form of lung disease. Recent efforts in early detection have given some hope of finding cancers early and improving survival. That is why the following information is so disturbing.

An increasing number of lung cancer patients are reporting that they have never smoked. Three well respected institutions that serve a diverse population of patients report that the proportion of lung cancer patients that had never smoked has risen from 9% to 15% in the last 24 years. This rise has been in patients afflicted with so-called non-small cell cancer. There has been no significant rise in the small cell group. In patients undergoing surgery for lung cancer the number of non-smokers has risen from 13% to 27% in the last 7 years. Several types of analysis have been applied to these numbers but no explanation has yet been found.

These facts are disturbing in a number of ways particularly since the early detection program in high risk groups has helped to reduce mortality. Non-smokers are not part of this screening population and using these techniques would be cost prohibitive. What is needed now is some effective non-invasive way to screen the general population. These non-invasive techniques would include blood and molecular testing. Until these
tests become available we need to be aggressive with abnormal findings in the lungs of non- smokers as well as those at higher risk.