Lung cancer rates increasing among nonsmoking Asian American women: study

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A California study reveals a decline in lung cancer rates across various groups, except for nonsmoking Asian American women, where rates are increasing by 2% annually.

The data: In the study published in the Chest medical journal, researchers found lung cancer incidence rates among Asian American females who have never used tobacco are approximately twice as high compared to their counterparts. Despite the association of lung cancer with smokers, up to 20% of U.S. cases reportedly occur in nonsmokers each year. Among Asian American women with lung cancer, over 50% are nonsmokers, rising to 80 to 90% for Chinese and Indian American women.

Further research: The perplexing trend has prompted extensive research, with ongoing studies at the University of California, San Francisco (UCSF) and New York University (NYU), aiming to understand the heightened risk in Asian American women and improve early detection methods. Concerned doctors and researchers are now advocating for revised screening guidelines to better address the increasing incidence of lung cancer in this community.

“We have to find out more of the causes,” study co-author Jeffrey Velotta told AJMC. “I think that this brings to the forefront, that this is a problem, we need to study this problem, and we need to take it more seriously. Something that we're working on next is to figure out, what is the issue? What are the main causes?”

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Risk factors: UCSF epidemiologists Scarlett Gomez and Iona Cheng are reportedly leading the Female Asian Never Smokers (FANS) study to find and understand risk factors for lung cancer in Asian American women, particularly nonsmokers. FANS, initiated in 2021, aims to identify genetic and environmental differences between recently diagnosed nonsmoking Asian American women with lung cancer and those without. Previous studies in Asia highlighted factors such as cooking oil fumes, secondhand smoke and air pollution.

Inadequate research: The inadequacy of research funding for Asian American women currently hinders progress. Lung cancer screening reportedly falls short for nonsmoking Asian American women due to guidelines tailored for heavy smoking histories and trials involving predominantly white elderly smokers. Factors like lack of awareness, cultural nuances and poor-quality data contribute to underreported cases, reinforcing racial stereotypes.

About the study: The study, which was published in September 2023, utilized electronic health record and cancer registry data from a dynamic cohort of adults aged 30 and above, spanning from 2007 to 2018 in northern California. The cohort included 3,751,348 adults, of which 63.1% had never used tobacco.

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