Lung Cancer Screening in Asians Who Have Never Smoked: We Still Need to Figure Out the Who and How

Abstract

Despite major advances in treatment, lung cancer remains the leading cause of cancer-related mortality in the United States and worldwide. Early detection via annual screening with low-dose computed tomography (LDCT) imaging has been shown to improve mortality in certain high-risk populations with a significant smoking history and is currently standard of care in the United States. However, a significant proportion of lung cancer occurs in people who have never smoked and do not meet the screening criteria, especially among women and individuals from countries in East Asia. There have been several observational studies conducted in East Asia that show LDCT screening detects lung cancer in never smokers, though they were not designed to show a mortality benefit and there is concern that the lung cancers detected largely represent overdiagnosis of indolent cancers. How to go about screening these populations requires careful consideration as every screening protocol needs to have its benefits balanced against the risks. More research is needed to determine the best screening strategy for this population.