Lung cancer has long been associated with smoking, but recent trends in the United States show a disturbing rise in lung cancer diagnoses among young and middle-aged women, many of whom have never smoked. This shift has drawn attention to a growing health crisis that medical experts are still trying to fully understand.
Susan Wojcicki, the former CEO of YouTube, was among those who experienced this firsthand. Diagnosed with lung cancer in 2022, Wojcicki, who had never smoked and was an active runner, shared her journey publicly in a blog post just weeks before her death in August 2024. In her post, she emphasized the alarming increase in lung cancer cases among nonsmokers, particularly women. Wojcicki’s death has drawn attention to a disturbing trend: more women are being diagnosed with lung cancer at higher rates than men, despite having no smoking history.
In her blog, Wojcicki called for more resources to be directed toward lung cancer research, specifically focusing on women and nonsmokers. Her message resonated with many as it highlighted the unpredictability of the disease and the need for better detection and understanding.
One such case is that of Jhalene Mundin, a 36-year-old nurse from New Jersey, who was diagnosed with stage IV lung cancer despite having no risk factors or history of smoking. Mundin had been experiencing a persistent cough, which she initially thought was a lingering symptom of COVID-19. However, a chest X-ray revealed a large mass, and she was soon diagnosed with advanced lung cancer. “It was totally unexpected,” Mundin recalled. “I thought it was maybe stage II or III, but when they told me it was stage IV, it felt like the room was closing in on me.”
Mundin’s story is not unique. Research indicates that lung cancer diagnoses have risen 84% among women in the US over the past four decades, while diagnoses in men have decreased by 36%. Particularly alarming is the fact that two-thirds of these cases are in women who have never smoked. In fact, nonsmokers are now more likely to develop lung cancer than male nonsmokers.
Dr. Helena Yu, a thoracic oncologist at Memorial Sloan Kettering Cancer Center, explained that exposure to environmental factors such as air pollution, secondhand smoke, and radon might contribute to this increase, but a significant factor could be genetic mutations. Many women with lung cancer, especially those who have never smoked, are found to have genetic mutations that contribute to the disease. These mutations, such as those in the epidermal growth factor receptor (EGFR), are more common in women and may explain the rise in lung cancer cases among this group.
Mundin, for example, was later told by her doctor that her cancer was likely caused by an EGFR mutation, a common genetic factor in lung cancer patients who have no history of smoking. This discovery sparked frustration for Mundin, who felt that she had never been informed about the risks of such genetic mutations, despite being a nurse herself. “If I had known, I would have been more proactive,” she said.
Another patient, Kara, 38, was also diagnosed with EGFR lung cancer. Kara, who was otherwise healthy, experienced shoulder and arm pain, which led to an MRI revealing a malignant tumor. After further tests, doctors confirmed that the cancer originated in her lungs, and she was diagnosed with stage IV lung cancer. Kara, who had no history of smoking, found the diagnosis shocking and unexpected but remains hopeful as she undergoes treatment. “I’m living my life normally. I run marathons, I’m still traveling, and I’m feeling great,” she said.
Experts like Dr. Alexander Drilon, who treats patients with lung cancer caused by genetic mutations, say that young women are being diagnosed with lung cancer at an increasing rate. This group of patients often presents with cancer that has specific genetic targets, such as EGFR mutations. Drilon is hopeful that new targeted therapies will continue to improve outcomes for these patients, allowing them to live longer, healthier lives.
The growing trend of lung cancer in young women has raised concerns about the need for more research. In 2023, US lawmakers introduced the Women and Lung Cancer Research and Preventative Services Act to address this issue. The legislation aims to improve research into lung cancer in women, particularly in identifying better screening, diagnosis, and treatment options.
Despite these efforts, lung cancer remains one of the least-funded areas of cancer research, particularly when it comes to women’s health. In 2019, only 15% of the National Institutes of Health’s lung cancer budget was allocated to research focused on women. However, lung cancer kills more women in the US than breast, ovarian, and cervical cancers combined.
In an effort to address this issue, some researchers are exploring ways to identify high-risk nonsmokers who might benefit from lung cancer screening. Studies such as the TALENT study in Taiwan, which screened nonsmokers with low-dose CT scans, found that a small percentage of participants were diagnosed with lung cancer, suggesting that early detection may help improve survival rates.
Despite the challenges, there is hope that continued research into lung cancer, especially in women and nonsmokers, will lead to better outcomes. For women like Mundin, Kara, and others, it is critical that more awareness is raised about this issue and that more resources are dedicated to finding a cure.
