Lung Cancer in Never Smokers-An Underappreciated Public Health Burden.

BACKGROUND: Lung cancer in lifelong never-smokers represents a significant public health burden, although it is underappreciated. Lung cancer in never smokers (LCINS) accounts for a substantial proportion of lung cancer cases, representing ~15%-25% depending on the geographic region. If considered as a separate disease entity, LCINS would represent a major cause of cancer-related mortality. DISCUSSION: Importantly, never-smokers with lung cancer have distinct epidemiology, molecular alterations, and therapeutic opportunities that differ from those of tobacco-related lung cancer. This perspective addresses lung cancer in lifelong never-smokers from four perspectives: epidemiology and incidence, molecular landscape and treatment, screening and early detection, and public health strategies. CONCLUSION: This perspective highlights that a comprehensive approach to lung cancer in never-smokers can meaningfully reduce the burden of disease through comprehensive screening approaches, stringent environmental regulations, molecular characterization of cancer, and educational approaches aimed at preventing disease.