Lung cancer in non-smoking women: “A women’s health crisis”

Lung cancer is the leading cause of cancer death in American women — and a growing share of new cases are in women who’ve never smoked.

Former YouTube CEO Susan Wojcicki was one of those women. A non-smoker, she died nearly two years ago of lung cancer at age 56. It was such a shock. I had interviewed Susan over the years and she had been to my home for a walk and met my children. I so admired her as a friend, a mom to five children, and a female tech leader. 

Her sister, Anne Wojcicki, sat down with me for my latest episode of “Healthful,” to discuss an urgent threat to women’s health. We were joined by Anne’s friend, Shira Kupperman Boehler — a nonsmoker who was diagnosed with stage 1B lung cancer at 44 — and Dr. Kim Sandler, director of the Vanderbilt Lung Screening Program.

“This is a women’s health crisis, but we don’t talk about it,” Dr. Sandler told me. 

So we talked about it at length: everything from risk factors to current and future screening options. Here’s what I learned from our conversation — I hope you’ll take the time to watch it on YouTube and listen wherever you get your podcasts:

Lung cancer kills more people than breast, pancreatic and ovarian cancer combined

Lung cancer causes more cancer deaths each year than breast cancer, pancreatic cancer and ovarian cancer combined – in part because once a patient starts experiencing symptoms, it’s often too late. According to a 2023 study published in The Journal of Radiology, patients who are diagnosed with lung cancer in stages I or II have a survival rate of 81%. Contrast that with the 10% survival rate of those diagnosed with late stage lung cancer, per the American Lung Cancer Association. 

The screening is easy — but it’s not recommended for many who would benefit from it

Low-dose CT scans are a quick, easy way to screen for lung cancer early, when it’s most treatable. Current American Lung Cancer guidelines recommend the scan for people over 50 who have a 20-pack year history – with a pack-year being defined as “equal to smoking 1 pack (or about 20 cigarettes) per day for a year.”

But roughly 20% of lung cancer cases are in non-smokers, and women who have never smoked account for two-thirds of those cases. Shira said she’d like to see lung cancer screening happen at age 40, like a mammogram. “The problem is we don’t feel our lungs until it’s too late, until the cancer has spread to our bones, to our brain, and then it is the number one cancer killer.”

Breast cancer survivors are at increased risk of getting lung cancer

Dr. Sandler told us: “We think about cancer as lightning striking. ‘I’ve had this disease. I should never have to deal with this again. I’m so fortunate that I’ve come out on the other side.’ And the truth is that once we have cancer once, we’re actually at an increased risk of developing cancer again, and lung cancer is the most common cancer to develop after breast cancer.”