Lung Cancer in Never Smokers

Lung cancer is a research priority in the UK. It is the most common cause of cancer death in the UK, accounting for more than one-fifth (21%) of all cancer deaths (2017-2019). It is traditionally thought of as a smoking-related disease, although it can occur in never-smokers. The proportion of lung cancer in people who have never-smoked ranges from 10% to 25% worldwide and is around15% in the UK. It is the seventh leading cause of cancer deaths in the world, killing more people every year than pancreatic or prostate cancers. British TV presenter Roy Castle, and former Secretary of State for Northern Ireland James Brokenshire, were never smokers diagnosed with lung cancer. Both died 2.5 years after their diagnosis. Lung cancer in never smokers is more common than people think. Despite this, there is not enough research focused on lung cancer in never smokers. It is time to give this disease more attention.

Lung cancer could happen in healthy never smokers. It would be helpful for general practitioners (GPs) to have more information on who is at the highest risk of developing lung cancer among the never-smoked population. A risk prediction model can help achieve this goal. Primary care is a service with almost whole population coverage in the UK, which will be a useful setting for early detection and diagnosis of lung cancer in never-smokers. Furthermore, the model can help communicate the risk between patients and GPs. Patients can know their risk and those at high risk may benefit from proactive medical surveillance and timely interventions. Based on this idea, we propose searching the medical literature to collect current research evidence on prediction models for lung cancer in never smokers (Stage 1). We will follow best practices to conduct this study. After finishing this study, we will use the findings to apply for other funding to test whether the current models are good enough to use in the UK primary care population or not (Stage 2-A). If not, we will develop and validate a new model (Stage 2-B).

In summary, we aim to determine the evidence base for early detection and diagnosis of lung cancer in never smokers from the UK primary care setting. This work is the first step to developing a calculator that GPs can use to help them identify never-smokers at the highest risk of lung cancer. This may help early diagnosis of the disease, reduce mortality, save more lives, improve patients’ quality of life, ease the NHS burden, and have substantial societal benefits.

Amount awarded: £42,036