ArticleBMJ open2025
Trends in the incidence of lung cancer in never smokers in Eastern China: a retrospective population-based cohort study using regional electronic health records.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of PD-1/PD-L1 inhibitors combined with multi-targeted anti-angiogenic TKIs in advanced or metastatic NSCLC: A meta-analysis based on RCTs.Frontiers in oncology · 2026Pooled it
- A radiotherapy-related fibrosis gene signature-based risk model for predicting prognosis and immunological features in lung adenocarcinoma.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Article
- Nanotechnology-Enabled Precision Therapy for Lung Cancer in Never-Smokers.Pharmaceutics · 2026Review
- Beyond tobacco: understanding the growing burden of lung adenocarcinoma in women.Oncology reviews · 2026Review
- Editorial: Increasing Awareness of Lung Cancer in Non-Smokers and Never-Smokers Challenges Current Approaches to Prevention and Screening.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Predictive Factors and Nomogram for Malignant Pulmonary Nodules (≤ 1 cm).Canadian respiratory journal · 2026Article
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8 authors.
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Abstract
objectivesAlthough lung cancer in never smokers (LCNSs) accounts for an estimated 25% of all lung cancer cases, the temporal trends in LCNS incidence and its broader epidemiological patterns remain poorly understood. Our study examines the temporal trends in LCNS incidence and analyses key epidemiological characteristics, specifically, the trends in mortality rates, survival rates and changes in age at onset to illuminate the reasons for temporal trends in LCNS incidence.
designRetrospective population-based cohort study.
settingRegional electronic health record (EHR) database linked to the cancer registry in eastern China.
participantsA total of 1 080 317 adults who have never smoked were included, among whom 4061 incident lung cancer cases were identified between 1 January 2009 and 31 December 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: The temporal trends in LCNS incidence in a large population-based dynamic cohort were estimated, overall and separately by sex, age group and histological types. The broader epidemiological patterns of LCNS, such as trends in mortality rates, survival rates and changes in age at onset, were analysed.
resultsFrom 2009 through 2020, the incidence of LCNS among men increased significantly from 9.51 to 43.4 per 100 000 (average annual percentage change (AAPC) 10.51%; 95% CI (6.88% to 14.26%)) whereas a sharper increase was observed among women from 3.57 to 51.68 per 100 000 (AAPC 22.39%; 95% CI (18.36% to 26.55%)). The 2-year survival of LCNS improved from 39% in 2010 to 64% in 2018 for men, and from 57% in 2009 to 86% in 2020 for women, while the mortality from LCNS remained stable from 2014 through 2020 (men: AAPC -1.77%; 95% CI (-8.95% to 5.97%); women: AAPC 2.19%; 95% CI (-4.09% to 8.89%)). The increasing trend in LCNS incidence was observed across most of the age groups except the elderly population aged ≥85 years in both sexes and the men aged 45-54 years, but the increase was most evident in the younger population aged <45 years (men: AAPC 21.10%; 95% CI (3.57% to 41.60%); women: AAPC 32.05%; 95% CI (23.73% to 40.92%)). The incidence of adenocarcinoma increased sharply in both sexes, whereas the incidence of non-adenocarcinoma histological types either increased slightly or remained stable. The standardised average age at onset of LCNS decreased significantly over time among women (β=-0.58, robust SE=0.16, p=0.005) but not among men (β=-0.21, SE=0.15, p=0.189).
conclusionsThere is a substantial increase in LCNS incidence, especially among women and young populations. However, the reason for these observed trends remains unclear and warrants investigation.
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