Approximately 50% of Asian American Women Diagnosed with Lung Cancer Have Never Smoked

Currently, researchers are mystified by new statistics showing that approximately 50% of Asian American women who have been diagnosed with lung cancer have never smoked.

Adding Indian American women with lung cancer brings the total to approximately 80 to 90%.

A Case in Point

As reported in NBC News, at the age of 28, Aurora Lucas was told that she had stage 3 lung cancer. Yet Aurora had never smoked. In 2021, Aurora developed a chest pain and a severe cough, but her doctors did not address her symptoms.

After several months of visits to the hospital, Aurora was told that she had lung cancer. She explains that as an Asian woman, she was raised to be respectful and remain quiet, with a high respect for her doctors as well as the medical staff. Therefore, it was unthinkable for her to question the staff even when they admitted that they did not have answers for her.

Aurora is Filipina American. Her case raised many red flags among researchers who saw it as an alarming trend. A study by a team in California found that rates of cancer going down for almost every group with the exception of Asian American women that don’t smoke. In that group, rates have increased by two percent each year.

We are told that lung cancer is associated with tobacco use, and especially cigarettes. However, approximately 20% of cases in the United States happen every year to people who have never smoked. Scientists are not only mystified but they are also scrambling to find the reason behind the phenomena and are determined to interrupt the tumors earlier. This has prompted a surge in research that includes three blockbuster studies at universities in New York, San Francisco, and California.

Doctors are sounding an alarm as they are concerned about the increasing number of lung cancers in this group. It is imperative that screening guidelines are expanded to involve these Asian American women.

Possible Risk Factors        

Scarlett Gomez immigrated from Taiwan to the United States when she was seven years old. Both parents worked in restaurants in the state of Washington and were continuously exposed to fumes from toxic cooking oils. Scarlett, who is now a UCSF epidemiologist, told NBC News that her parents worked in jobs that were well below their training. She explained that is what they had to in order to survive in the United States.

Several possible risk factors have been identified such as fumes from cooking oil, secondhand smoke, using coal for indoor heating, and air pollution. Scarlett points out that to date, there has not been any research that is specifically focused on women of Asian descent. One 2019 study shed some light on the fact that Asian Americans inhale 73% more particles of pollution than their White American counterparts. It is assumed that they have a greater exposure to industry, vehicle emissions, and construction.

In 2021 Scarlett, together with Iona Cheng who is also a UCSF epidemiologist, launched the Female Asian Never Smokers (FANS) study. The researchers are focusing on cases pertaining to Asian American women nonsmokers who were recently given a lung cancer diagnosis and the controls, which are people who don’t have lung cancer. The goal of the study is to find risk factors.

A Stanford University physician who was not involved in the study, Dr. Latha Palaniappan, termed the 2021 study as “groundbreaking” due to its focus on creating more equitable lung cancer screening. He feels the study will eventually provide a wider array of analyses.

Dr. Elaine Shum, oncologist, explains her frustration at seeing so many nonsmoking Asian Americans who have lung cancer. Many of these women are at stage 4. The doctor explains that they could have been helped and their tumors discovered earlier through low-dose CT scan when they were at a more treatable stage.

Dr. Shum said that insurance plans generally cover screening for people 50 to 80 years of age who have a history of heavy smoking. This, of course, almost entirely excludes Asian American women. The National Lung Screening Trial was the basis for the recommendations. It is a trial involving 53,000 elderly (90% white) smokers.
In 2021 Dr. Shum launched a clinical trial that involved lung cancer screening given to 1,000 Asian American women who had never smoked. The doctor presented the initial results at a cancer conference showing that Asian women’s rate of cancer detection was higher than the national trial (1.5% vs. 1%). Dr. Shum concluded her findings by saying the preliminary data confirms that Asian women are high-risk and warrant screening.

Dr. Palaniappan agrees with Dr. Shum. Asian women are often lumped into the “other” category in surveys. Dr. Palaniappan noted that screening guidelines for Asian American women remain a future endeavor requiring more studies.

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Last modified: May 31, 2024