For decades, lung cancer came with a stereotype: older, male and a longtime smoker. That stereotype is not only outdated. It can be dangerous.
Lung cancer is the leading cause of cancer death in the United States, and it kills more women than any other cancer. Yet it remains surprisingly absent from many women’s routine health conversations. We talk about mammograms, Pap tests, colonoscopies and skin checks. Far fewer women know whether they should be screened for lung cancer, or understand that people who have never smoked can develop it too.
To be clear, smoking remains the most significant risk factor for lung cancer. But, it is not the only one. An estimated 10% to 20% of lung cancers occur in people who have never smoked, and lung cancer among never-smokers occurs more frequently in women than in men.
Incidents of Lung Cancer in Men vs. Women
For decades, lung cancer was considered predominantly a man's disease. Today, that narrative is changing and women need to know why. According to the American Lung Association, over the past 42 years, lung cancer diagnoses in men have declined by 36%, while diagnoses among women have increased by an alarming 84%.
Even more concerning, a landmark JAMA Oncology study found that among adults ages 35 to 54, women now have higher lung cancer incidence rates than men of the same age. Researchers observed that while lung cancer rates have declined in both sexes, the decline has been far steeper in men.
What's especially troubling is that smoking alone does not fully explain this shift. Scientists are actively investigating additional contributors, including genetic susceptibility, hormonal influences, environmental exposures such as radon and air pollution, and the increasing recognition of lung cancer in people who have never smoked.
A Family Loss Becomes a Mission
That gap in understanding is now receiving high-profile attention, thanks in part to Anne Wojcicki and her family. Susan Wojcicki, the former CEO of YouTube and Anne Wojcicki’s sister, was diagnosed with non-small cell lung cancer in late 2022. She had never smoked and reportedly experienced few noticeable symptoms before her diagnosis. She died in August 2024 at age 56.
In May 2026, the Troper and Wojcicki families launched the Susan Wojcicki Foundation, committing $150 million in founding support. The foundation is focused on changing how lung cancer risk is identified, improving early detection and accelerating research, particularly for people who do not fit the traditional high-risk profile. Additional support has come from Google, Salesforce and Melinda French Gates.
Anne Wojcicki, co-founder of 23andMe, has been actively involved in raising awareness of the central question behind the initiative: Who is actually at risk for lung cancer? The answer, increasingly, appears to be more complicated than smoking history alone.
The foundation is supporting work involving genetics, risk identification and earlier detection. It has also partnered with the Lung Cancer Research Foundation to explore what inherited genetic information, not just genetic testing of a tumor after diagnosis, may teach researchers about lung cancer risk.
Yes, Women Who Have Never Smoked Can Get Lung Cancer
Smoking causes the large majority of lung cancer deaths, so quitting, or never starting, is still the most powerful preventive step available. But the assumption that “I don’t smoke, so I can’t get lung cancer” is incorrect.
Potential risk factors for people who have never smoked include:
- Radon exposure
- Secondhand smoke
- Outdoor air pollution
- Asbestos and other workplace exposures
- Previous radiation treatment to the chest
- Certain chronic lung diseases
- A family history of lung cancer
- Genetic and biological factors that researchers are still working to understand
Radon deserves particular attention. It is an invisible, odorless radioactive gas that can enter homes through the ground. The Environmental Protection Agency estimates that radon causes approximately 21,000 lung cancer deaths in the United States each year, making it the second-leading cause of lung cancer deaths after smoking. It can cause lung cancer in people who have never smoked.
Who Should Be Screened for Lung Cancer?
Unlike a mammogram, there is currently no routine lung cancer screening recommendation for every woman once she reaches a certain age.
The recommended test is an annual low-dose CT scan, often called an LDCT. A chest X-ray is not considered an appropriate substitute for lung cancer screening.
The American Cancer Society recommends annual low-dose CT screening for people who:
- Are between ages 50 and 80
- Currently smoke or previously smoked
- Have at least a 20 pack-year smoking history
A “pack-year” is a way of measuring lifetime smoking exposure. Smoking one pack a day for 20 years equals 20 pack-years. Smoking two packs a day for 10 years also equals 20 pack-years.
The U.S. Preventive Services Task Force uses similar criteria but recommends screening for current smokers or people who quit within the past 15 years.
Screening is intended for people who do not currently have symptoms. If you have symptoms, you need a diagnostic evaluation, not a screening appointment.
Symptoms Women Should Not Ignore
Early lung cancer may cause no symptoms, which is one reason it can be difficult to detect. When symptoms do appear, they can be mistaken for asthma, a lingering respiratory infection, stress, allergies or simply being out of shape.
Contact your healthcare provider if you experience:
- A cough that does not go away or continues to worsen
- Coughing up blood, even a small amount
- Unexplained shortness of breath
- Chest, shoulder or upper-back pain
- New or persistent wheezing
- Repeated pneumonia or bronchitis
- A hoarse voice that persists
- Unexplained fatigue
- Unintentional weight loss or loss of appetite
These symptoms are far more likely to have a noncancerous cause. But persistent or worsening symptoms deserve an explanation, especially when they are new for you. Do not let the absence of a smoking history end the conversation.
Earlier Detection Is Urgent
There is no guaranteed way to prevent every case of lung cancer. A woman can exercise, eat well, never smoke and still develop the disease. That is not a reason to feel helpless. It is a reason to replace blame with better science.
Reduce the risks you can control.
- Test your home for radon
- Avoid tobacco smoke
- Understand your family and exposure history
- Find out whether you qualify for low-dose CT screening
- Do not ignore persistent symptoms simply because you have never smoked
Conclusion
The takeaway is clear: women should understand that lung cancer is no longer just a smoker's disease or a men's disease, making awareness of symptoms, risk factors, and appropriate screening more important than ever. Awareness cannot prevent every case, but it can lead to earlier detection, better research and more lives saved.
