Presentation and stage-specific outcomes of lifelong never-smokers with non-small cell lung cancer (NSCLC)

J Thorac Oncol. 2007 Sep;2(9):827-30. doi: 10.1097/JTO.0b013e318145af79.


Background: Tobacco smoking leads to lung cancer. Approximately 10% of patients with lung cancer are life long never-smokers. There are only limited data available on the clinical characteristics and outcomes of lung cancer in never-smokers from the Western hemisphere.

Methods: Demographic and survival information was collected on 254 never-smokers with a confirmed pathologic diagnosis of non-small cell lung cancer (NSCLC) by reviewing their medical records and the Social Security database.

Results: The study population consisted of 182 (71.6%) women and 72 (28.3%) men. The median age was 70 years (range: 31-91 years). Adenocarcinoma was the most common histology accounting for 60.8% of all patients, followed by NSCLC not otherwise specified (14.4%), bronchoalveolar carcinoma (13.6%), squamous cell carcinoma (8.8%), and large-cell type (2.4%). Majority of patients presented with stage III or IV disease (62.5%). We compared survival between never-smokers and smokers with NSCLC matched for gender, histology, tumor stage, and years of diagnosis. No significant difference in 5-year survival was seen between never-smokers (27.2%) and smokers with NSCLC (31.3%; p = 0.73).

Conclusions: Two thirds of patients with lung cancer who report no history of tobacco smoking are women. In the matched case-control analysis, we report no significant survival difference between lung cancer in never-smokers and those with history of tobacco smoking and lung cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / mortality*
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Missouri / epidemiology
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Smoking / adverse effects*
  • Survival Rate / trends