Cancer Communications
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[ Special series on lung cancer 2 ]
doi: 10.1186/s40880-017-0187-6
Proportion and clinical features of never-smokers with non-small cell lung cancer
Jaeyoung Cho, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Dong-Wan Kim, Jae-Joon Yim, Young Tae Kim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han and Young Sik Park
Department of Internal Medicine, Seoul National University Hospital
[Abstract]

Background
The proportion of never-smokers with non-small cell lung cancer (NSCLC) is increasing, but that in Korea has not been well addressed in a large population. We aimed to evaluate the proportion and clinical features of never-smokers with NSCLC in a large single institution.
Methods
We analyzed clinical data of 1860 consecutive patients who were newly diagnosed with NSCLC between June 2011 and December 2014.
Results
Of the 1860 NSCLC patients, 707 (38.0%) were never-smokers. The proportions of women (83.7% vs. 5.6%) and adenocarcinoma (89.8% vs. 44.9%) were higher among never-smokers than among ever-smokers. Significantly more never-smokers were diagnosed at a younger median age (65 vs. 68 years, P < 0.001) and earlier stage (stage I–II, 44.5% vs. 38.9%, P = 0.015) compared with ever-smokers. Epidermal growth factor receptor mutations (57.8% vs. 24.4%, P < 0.001) and anaplastic lymphoma kinase rearrangements (7.8% vs. 2.8%, P < 0.001) were more common in never-smokers, whereas Kirsten rat sarcoma viral oncogene homolog mutations (5.8% vs. 9.6%, P = 0.021) were less frequently encountered in never-smokers than in ever-smokers. Never-smokers showed longer survival after adjusting for the favorable effects of younger age, female sex, adenocarcinoma histology, better performance status, early stage disease, being asymptomatic at diagnosis, received antitumor treatment, and the presence of driver mutations (hazard ratio, 0.624; 95% confidence interval, 0.460–0.848; P = 0.003).
Conclusions
More than one-third of the Korean patients with NSCLC were never-smokers. NSCLC in never-smokers had different clinical characteristics and major driver mutations and resulted in longer overall survival compared with NSCLC in ever-smokers.
Chinese Journal of Cancer 2017, Volume: 36, Issue 2
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Jaeyoung Cho, Sun Mi Choi, Jinwoo Lee, Chang-Hoon Lee, Sang-Min Lee, Dong-Wan Kim, Jae-Joon Yim, Young Tae Kim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han and Young Sik Park. Proportion and clinical features of never-smokers with non-small cell lung cancer. Chin J Cancer. 2017, 36:20. doi:10.1186/s40880-017-0187-6


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