Lung cancer rising among Asian women nonsmokers in Northern California

Asian women who have never smoked in Northern California are experiencing a sharp and underrecognized rise in lung cancer, eight years of Kaiser Permanente data show. In a recent analysis led by Jeffrey B. Velotta, thoracic surgeon at Kaiser Permanente Northern California, incidence in this group has doubled, climbing roughly 2% annually. Doctors warn that traditional screening guidelines miss many of these high-risk patients, prompting calls for greater awareness and earlier detection.

Velotta and his team examined lung cancer incidence among all Kaiser Permanente members over the past eight years, including patients of different races, genders, and smoking histories. “Not surprisingly, lung cancer, whether you smoke or not, was dramatically decreasing in all races and ethnicities other than Asian, like white, Black, and Latin,” he said. The analysis confirmed that Asian nonsmoking women, and to a lesser extent men, are experiencing a steady increase in diagnoses, a trend observed across Northern California rather than limited to individual clinics.

Current U.S. lung cancer screening guidelines focus primarily on older adults with a history of smoking, leaving nonsmoking Asian women largely unscreened. According to Velotta, recognizing this trend allows physicians to alert patients that risk exists even without tobacco exposure. “When we found that, it verified that this trend is truly happening, and it’s not just a phenomenon I was seeing in the clinic,” he said, underscoring the gap between guideline criteria and emerging risk patterns.

The rising incidence among Asian nonsmoking women has prompted calls for broader research into genetic, environmental, and social factors that may contribute to risk. Ongoing studies such as the Female Asian Never Smokers (FANS) study at UCSF are investigating environmental exposures and genetic factors to better understand why this population is disproportionately affected. Experts emphasize that earlier detection and targeted screening could improve outcomes for this group, and healthcare providers in Northern California are beginning to incorporate these findings into patient outreach and education.