Can You Get Lung Cancer Without Smoking?

Doctor showing lung x-ray to patient

OHIOHEALTH

KEY TAKEAWAYS:
• You can get lung cancer even if you have never smoked. People who have never smoked account for an estimated 10 to 20 percent of all lung cancer cases, which means thousands of non-smokers receive this diagnosis every year.
• Several well-understood risk factors cause lung cancer in non-smokers. These include radon gas exposure, secondhand smoke, occupational exposures like asbestos, previous radiation treatment and family history or genetics.
• Early lung cancer is often symptom-free, so awareness matters. When symptoms do appear, they commonly include a persistent cough and shortness of breath, with more extreme signs such as weight loss, chest pain and coughing up blood.

SUMMARY:
Lung cancer is often viewed as a smoker’s disease, yet a meaningful share of cases — an estimated 10 to 20 percent — occur in people who have never smoked. Matthew Lamb, MD, a general thoracic surgeon at OhioHealth, explains the real risk factors for non-smokers: radon gas exposure, secondhand smoke, asbestos and other occupational exposures, previous radiation, and family history or genetics. Because early lung cancer is usually symptom-free, it’s important to be aware of the warning signs to watch for, including a persistent cough, shortness of breath, weight loss, chest pain and coughing up blood. While formal screening guidelines exist for smokers, non-smokers with known risk factors should discuss their personal risk and a possible low-dose CT scan with a primary care specialist.

Most people picture lung cancer as a smoker’s disease, yet a meaningful share of cases happen in people who have never smoked a cigarette. “Smoking is a significant risk factor, but not the only one,” says Matthew Lamb, MD, a general thoracic surgeon at OhioHealth. Understanding the other risk factors for lung cancer can help you to facilitate a conversation with your primary care specialist about lung cancer screenings. Find out more about lung cancer risk factors, common symptoms and when you should consider getting a screening.

How likely is it for non-smoker to get lung cancer?

Lung cancer in non-smokers is less common than in smokers, but it’s far from rare. Research shows that people who have never smoked account for an estimated 10 to 20 percent of all lung cancer cases. That means thousands of people who have never smoked cigarettes receive this diagnosis every year. “Anyone can get lung cancer,” Dr. Lamb says. Your history with smoking matters, but it doesn’t tell the whole story.

If tobacco isn’t the culprit, what is? Several lung cancer causes besides smoking are well understood. Knowing them helps you spot your own risk.

Common lung cancer risk factors for non-smokers include:

Radon gas. This is a big one, especially close to home. “Radon is a real risk in central Ohio,” Dr. Lamb says. “It’s the second leading environmental cause of lung cancer outside of smoking.” Radon is a natural gas that seeps up from the ground into basements and crawl spaces. You can’t see it or smell it, which is exactly why the radon gas lung cancer risk is so easy to overlook. A simple home test can tell you if it’s present, and a mitigation health system can clear it out.
Secondhand smoke. Growing up or living in a home with smokers adds up over time. The secondhand smoke lung cancer connection is well established, even for people who never smoked themselves.
Occupational and environmental exposures. Substances like asbestos, along with previous radiation treatment, can raise your risk.
Family history and genetics. Having a first-degree relative — like a parent or sibling — with lung cancer, can heighten your risk. Part of this may be genetic, and part may come from shared surroundings like secondhand smoke.

What are the common first signs of lung cancer?

Lung cancer is often quiet in its early stages, which is why awareness matters so much. “Symptomatically, there’s not much difference between how lung cancer appears in smokers and non-smokers,” explains Dr. Lamb. “That’s the problem. Lung cancer is largely asymptomatic until it’s too late.”

When symptoms do appear, they can be easy to brush off. “If patients have symptoms, it tends to be cough and shortness of breath,” explains Dr. Lamb. “The more extreme symptoms include weight loss, chest pain and coughing up blood.” Most of the time, the less extreme symptoms point to something far less serious than cancer. Still, if a cough lingers or your breathing feels off, it’s worth a conversation with your doctor rather than a wait-and-see approach.

When should you talk to your doctor or consider screening?

Screening guidelines for lung cancer are well established for people with a smoking history. For non-smokers, formal guidelines don’t yet exist, which makes your own awareness the most powerful tool you have. “If you are a non-smoker, you have to be hyper aware of your risks,” says Dr. Lamb. “You have to talk about that with your primary care physician.”

Start a conversation with your primary care provider if any of these apply to you:

You have a first-degree relative who had lung cancer.
You’ve lived in a home with known radon exposure.
You spent years around secondhand smoke.
You’ve had ongoing symptoms like a persistent cough or shortness of breath.

Sometimes getting a screening for peace of mind is worth pursuing. This can look like a low-dose CT scan, which is quick and can catch concerns early, when they’re most treatable.

Take the next step for your health

You don’t need a smoking history to care about your lung health. If any of these risk factors sound familiar, or if you simply want peace of mind, talk with your primary care specialist about your personal risk and whether a screening makes sense for you.

Want to schedule or learn more about lung cancer screenings? See our pulmonology resources.

Frequently asked questions

Can you get lung cancer without smoking?

Yes. While smoking is the leading cause, non-smokers can develop lung cancer from factors like radon, secondhand smoke, workplace exposures and genetic reasons.

Is radon really a concern in Ohio?

It is. Radon is the second leading environmental cause of lung cancer, and central Ohio’s geology makes local homes more likely to have elevated levels. A home test is an easy first step.