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AI-driven diagnostics, molecular profiling and precision therapies are transforming treatment outcomes, offering fresh hope for longer survival and possible cures

BENGALURU, July 31: Lung cancer is no longer viewed as a disease affecting only smokers. Medical experts are reporting a steady increase in cases among women, younger adults and people who have never smoked, pointing to the growing influence of air pollution, environmental exposure and changing lifestyles.

Ahead of World Lung Cancer Day, Dr. Radheshyam Naik, Senior Consultant Medical Oncologist and Head of the Bone Marrow Transplant (BMT) Unit at Sammprada Hospital, Bengaluru, said the long-held misconception that lung cancer occurs only in smokers is delaying diagnosis, particularly among non-smokers who often ignore early warning signs.

“Smoking continues to be the leading cause of lung cancer, but it is no longer the only factor,” Dr. Naik said. “We are increasingly diagnosing the disease in people who have never smoked, especially women and younger individuals. Passive smoking, vehicular pollution, indoor smoke from biomass fuels and naturally occurring radon gas are all emerging as significant contributors.”

According to him, passive smoking accounts for nearly 5-7 per cent of lung cancer cases, while traffic-related air pollution contributes to around 10 per cent. Exposure to radon gas is responsible for an estimated 10-15 per cent of lung cancers among non-smokers, with indoor pollution from traditional cooking methods also adding to the disease burden.

Dr. Naik said the nature of lung cancer has changed considerably over the past two decades. Earlier, smoking-related cancers such as squamous cell carcinoma and small-cell lung cancer, often associated with heavy tobacco and beedi use, were more common in India. Today, however, nearly 80 per cent of newly diagnosed cases are adenocarcinomas, mirroring trends seen in Western countries.

He attributed this shift to evolving smoking habits, increased use of filtered cigarettes and broader lifestyle changes.

Doctors are also seeing a growing number of younger patients and women being diagnosed with lung cancer. Although more research is needed to fully understand the reasons, Dr. Naik believes the trend is likely linked to multiple factors, including increasing tobacco use among women and adolescents, unhealthy diets, obesity, physical inactivity, alcohol consumption and worsening environmental pollution.

One of the most significant developments in lung cancer care has been the integration of artificial intelligence into diagnosis. AI is helping pathologists distinguish cancerous tissue from benign conditions while accurately identifying the specific subtype of lung cancer, enabling doctors to select the most appropriate treatment.

Artificial intelligence is also strengthening radiology by improving the interpretation of CT scans, helping identify suspicious lung nodules more accurately and determining which patients require further investigations such as biopsies or surgery.

“AI has become an important clinical support tool. It enhances diagnostic precision, reduces uncertainty and allows treatment to begin at an earlier stage,” Dr. Naik explained.

Another major breakthrough has been the widespread adoption of molecular profiling and biomarker testing, which have become central to modern lung cancer treatment. Instead of treating all lung cancers in the same way, doctors now analyse the genetic and immune characteristics of each tumour, allowing therapies to be tailored to individual patients.

“Molecular and biomarker testing help identify patients who are likely to benefit from targeted therapies or immunotherapy. These tests have become indispensable for delivering the most effective treatment,” he said.

He added that advances in targeted medicines and immunotherapy are improving outcomes not only for patients with advanced lung cancer but also for those diagnosed in the early stages, where these treatments are increasingly being used alongside surgery and radiation therapy.

While emphasizing that preventing tobacco use remains the most effective strategy against lung cancer, Dr. Naik expressed optimism about the future of treatment.

“The best protection is never to start smoking, and for smokers, quitting as early as possible remains crucial. At the same time, remarkable progress in genomics, immunotherapy and targeted treatments is changing the outlook for patients. Over the next five to ten years, we expect many patients to live significantly longer, and for some forms of lung cancer, complete cure could become a reality,” he said.

As India prepares to observe World Lung Cancer Day, Dr. Naik stressed the need to broaden public awareness beyond tobacco. He said recognising that lung cancer can affect non-smokers, women and younger adults, combined with timely diagnosis through advanced technologies and precision medicine, will be essential to reducing the country’s growing burden of the disease.

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