True or false: Lung cancer only affects those who have smoked a long time. The answer: False.
The actual connection between smoking and lung cancer is one of three key takeaways about lung cancer from the experts at Mount Sinai.
- Smoking is the leading cause of lung cancer, but not the only cause. Smoking is responsible for about 80 to 90 percent of lung cancer cases. But a growing number of nonsmokers are being diagnosed with lung cancer. The risk of lung cancer increases with the number of cigarettes smoked and how long someone has smoked. For non-smokers, a family history, secondhand smoke and exposure to chemicals like radon and asbestos can increase the risk of lung cancer.
- Lung cancer is the leading cause of cancer deaths. Lung cancer is the leading cause of cancer-related deaths worldwide, and is the deadliest type of cancer for both men and women.
- Early diagnosis is important. Lung cancer is often diagnosed at advanced stages, when treatment options are limited. Early diagnosis can make a big difference in survival rates.
The symptoms of lung cancer are the same whether or not you have smoked. Some people have general symptoms of not feeling well or feeling tired all the time, according to the Centers for Disease Control and Prevention. Some people cough frequently, cough up blood, or have chest pain, wheezing, or shortness of breath. These symptoms can happen with other illnesses. If you have any of these symptoms, talk to your doctor, who can help find the cause.
Here are more important updates on lung cancer prevention and treatment from the Center of Excellence for Thoracic Oncology, led by co-directors Fred R. Hirsch, MD, PhD, and Andrew J Kaufman, MD, and the entire team at Mount Sinai Health System have vast experience researching, detecting, and treating lung cancers.
These experts note a number of important developments in the field, including improved cure rates thanks to early detection of lung cancer through low-dose computed tomography (CT) scans and by raising awareness of lung cancer risk in “never smokers.” Artificial intelligence (AI) technology is helping to find lung cancer earlier and more accurately, while a recent study points to disparities in lung cancer testing.
Cure Rate From Early Detection
Research led by Claudia Henschke, MD, PhD, Professor of Diagnostic, Molecular and Interventional Radiology and Director of the Early Lung and Cardiac Action Program (ELCAP) at the Icahn School of Medicine at Mount Sinai, indicates that early detection works. In a multi-decade study (1992-2022) involving more than 31,000 people, those who detected lung cancer early through low-dose CT scans had an 81 percent survival rate after 20 years. The average five-year survival rate for all lung cancer patients is 28 percent, according to the American Cancer Society. However, only 23 percent of lung cancers are diagnosed at an early stage.
“Early detection is crucial in the fight against lung cancer,” said Dr. Henschke. “Our research shows that annual low-dose CT screening significantly increases survival rates by identifying cancers at their most treatable stages. We encourage individuals, especially those at higher risk, to take advantage of these screening opportunities.”
Lung Cancer in Never Smokers
According to the American Cancer Society, up to 20 percent of lung cancer cases occur in people who have never smoked. This fact helps us understand that lung cancer can affect anyone, not just smokers. Factors like exposure to secondhand smoke, radon, air pollution, asbestos, or a family history of lung cancer may increase your risk of lung cancer. Researchers estimate that second-hand smoke contributes to about 7,300 and radon to about 2,900 of these cases. Mount Sinai offers a program that allows individuals 40 and older to be screened even if they have little to no smoking history.
“Lung cancer is often associated with smoking, but it’s important to recognize that it can develop in people who have never smoked or have smoked very little—fewer than 100 cigarettes in their lifetime,” said Raja Flores, MD, Chair of Thoracic Surgery at the Mount Sinai Health System. “In fact, about 10-20 percent of lung cancers in the United States occur in individuals who have never smoked. Lung Cancer Awareness Month is an important time to highlight that many factors beyond smoking influence an individual’s lifetime risk for lung cancer. We need education about exposure and subsequent access to testing to improve early detection in all populations, regardless of smoking history.”
Using Artificial Intelligence (AI) in Screening
Icahn Mount Sinai is advancing the use of AI technology to find lung cancer earlier and more accurately. Recently developed by the I-ELCAP team, the Open Source Automated Image Reading System (AIRS) will analyze CT scans to spot nodules that might be missed by the human eye and assess a patient’s risk for lung cancer based on their medical history and other factors. Designed as a future “rule out” tool for annual repeat and follow-up low-dose CT scans, AIRS is expected to cut radiologists’ reading time by approximately 85 percent.
“Artificial intelligence is revolutionizing the way we approach lung cancer screening. By enhancing the analysis of CT scans, AI can help us detect growths earlier and more accurately than ever before,” said David F. Yankelevitz, MD, Director of the Lung Biopsy Service at Icahn Mount Sinai. “This technology is a tool not only to improve diagnostic precision but also to allow us to tailor screening protocols to individual patients, ultimately leading to better outcomes and survival rates.”
Disparities in Lung Cancer Testing
A recent Mount Sinai study found that people with lung cancer face significant differences in getting important tests based on their race and income. This study, led by Emanuela Taioli, MD, PhD, and her team at the Institute for Translational Epidemiology at Icahn Mount Sinai, identifies a serious concern in cancer care.
“The results of this study are important because they show that if we can fix these gaps in testing, more people will be able to get the treatments they need and improve their chances of survival,” said Dr. Taioli. “For doctors, this means they need to make sure that everyone has equal access to these important tests. For patients, especially those from lower-income or minority backgrounds, it means there’s a need for better access to treatments that can improve their health and improve their chances of survival.”
Accessing Care at Mount Sinai
Mount Sinai has broad experience with a variety of diagnostic tools and some of the most advanced treatment options in the New York City area. Here are a few of our locations across New York City and Long Island:
- Multiple Myeloma Program at The Ruttenberg Treatment Center 1470 Madison Avenue
- The Blavatnik Family Chelsea Medical Center at Mount Sinai, 325 West 15th Street
- Mount Sinai Brooklyn, 3201 Kings Highway, Brooklyn, NY
- Lung and Thoracic Cancer Services at The Mount Sinai Hospital, 1190 Fifth Avenue
- Mount Sinai South Nassau, One Healthy Way, Oceanside, NY
- Mount Sinai Queens, 25-20 30th Avenue, Astoria, NY
For more information, please visit www.mountsinai.org/lungcancer