Non small cell lung cancer risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2] Maria Fernanda Villarreal, M.D. [3]

Overview

Common risk factors in the development of non small cell lung are smoking, family history of lung cancer, high levels of air pollution, radiation therapy to the chest, radon gas, asbestos, occupational exposure to chemical carcinogens, and previous lung disease.

Common Risk Factors

Common risk factors non-small cell lung cancer may include:

• Smoking
• Second-hand smoke
• Family history of non-small cell lung cancer
• High levels of air pollution
• Radiation therapy to the chest
• Radon gas
• Asbestos
• High levels of arsenic in drinking water
• Occupational exposure to chemical carcinogens
• Previous lung disease
• Indoor burning of coal
• Weakened immune system
• Systemic lupus erythematosus

Smoking

• Cigarette smoking is the leading cause of non-small cell lung cancer.
  • Both active and passive smoking are associated with increased risk of non-small cell lung cancer.
  • The risk of non-small cell lung cancer is associated with increased quantity of cigarette smoking as well as increased duration of smoking.
  • There is no evidence that smoking low-tar cigarettes lowers the risk.
  • There is a parallel correlation between the amount of cigarettes and the proportional risk of non-small cell lung cancer.
• Recently introduced e-cigarettes, which were thought to be risk-free were recently demonstrated to be also associated with a significantly increased risk of non-small cell lung cancer due to the presence of formaldehyde.
• In the United States, smoking is estimated to account for 87% of non-small cell lung cancer cases (90% in men and 85% in women).
• There is approximately a 20 year lag period between smoking and death due to non-small cell lung cancer (in men).

Shown below is an image depicting the correlation between smoking and non-small cell lung cancer:

The incidence of lung cancer is highly correlated with smoking. Source: NIH

Second-hand smoke

• Second-hand smoke is what smokers exhale and what rises from a burning cigarette, pipe or cigar. It is also called environmental tobacco smoke (ETS), or involuntary or passive smoking.
  • Second-hand smoke contains the same chemicals as smoke that is actively inhaled.
  • People exposed to second-hand smoke have an increased risk of non-small cell lung cancer.
  • Second-hand smoke is the main risk factor for non-small cell lung cancer among non-smokers.
• There is no established amount of exposure to correlate safety and the risk of second-hand smoke.

Air Pollution

• Emissions from automobiles, factories and power plants are thought to pose potential risks.
• Researchers have shown that individual components of outdoor air pollution cause cancers (PAHs).
• Components include diesel engine exhaust, benzene, particulate matter and some polycyclic aromatic hydrocarbon.

Family History of Lung Cancer

A positive family history of non-small cell lung cancer may increase the risk of non-small cell lung cancer.

• First-degree relatives of people who have had non-small cell lung cancer may have a slightly higher risk of developing non-small cell lung cancer themselves.
• The increased risk among first-degree relatives could be due to a number of factors, such as shared behaviors or living in the same place where there are carcinogens.
• Studies of families with a strong history of non-small cell lung cancer have found that the increased risk might be due to a mutation in a non-small cell lung cancer gene.
• Other studies have shown that the risk of non-small cell lung cancer in a family increases if a family member developed the disease at an early age.

Radiation Therapy to the Chest

Positive history of radiation therapy to the chest increases the risk of non-small cell lung cancer due to the development of cellular damage and DNA mutations.

• The risk of non-small cell lung cancer increases for people who have had previous exposure to ionizing radiation.
• People who have been treated with radiation therapy to the chest for cancers such as Hodgkin lymphoma or breast cancer are at increased risk for non-small cell lung cancer.

Radon Exposure

Radon is a colorless, odorless, tasteless gas that comes from the natural breakdown of uranium in rocks and soil.

• Radon exposure increases the risk of non-small cell lung cancer.
• Radon is the leading cause of non-small cell lung cancer in non-smokers and the second leading cause in smokers.

Asbestos Exposure

Exposure to asbestos fibers in the air increases the risk of non-small cell lung cancer.

• The risk of asbestos exposure is highest for people who work with asbestos, such as miners.
• Studies have shown that the combination of smoking and asbestos exposure is especially hazardous.
• Patients that are exposed to asbestos and smoke are at even greater risk of developing non-small cell lung cancer.

Exposure to Other Chemical Carcinogens

Other chemical carcinogens associated with small cell lung cancer include:

• Arsenic and inorganic arsenic compounds
• Beryllium and beryllium compounds
• Cadmium and cadmium compounds
• Chemicals used in:
  • Rubber manufacturing
  • Iron
  • Steel founding
  • Paints
• Chloromethyl ethers and bis-chloromethyl ether
• Chromium (VI) compounds
• Cobalt-tungsten carbide
• Diesel engine exhaust
• Mustard gas
• Polycyclic aromatic hydrocarbons (PAHs)
• Radioactive ores such as uranium and plutonium
• Silica dust and crystalline silica
• Some nickel compounds

Less Common Risk Factors

Less common risk factors non small cell lung cancer may include:

• Occupational exposure to certain chemicals
• Vinyl chloride
• Dioxin
• Cobalt-tungsten carbide
• Inorganic acid mists
• Smoking marijuana
• Indoor burning of wood
• High-temperature frying
• Meat-diet
• Physical inactivity

References

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