WCLC 2025 - Posters & ePosters-P3.01.46 Characterization of Patients With Lung Cancer Not Meeting Lung Cancer Screening Criteria: Identifying a High-Risk Group Beyond Tobacco Smoking

P3.01.46 Characterization of Patients With Lung Cancer Not Meeting Lung Cancer Screening Criteria: Identifying a High-Risk Group Beyond Tobacco Smoking

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This prospective study examined 350 patients with all stages of non-small cell lung cancer (NSCLC) treated at Hospital Clinic of Barcelona from October 2020 to January 2025. Researchers collected detailed personal interviews documenting familial and personal cancer history over three generations, demographics, and carcinogen exposures, alongside clinical and molecular data from medical records. Patients were categorized as eligible or ineligible for lung cancer screening (LCS) based on Nelson criteria, which primarily consider age and smoking history (current/former smokers aged 50-74 with significant tobacco exposure).<br /><br />Results showed that 62% (217 patients) of NSCLC cases did not meet existing LCS criteria due to young or old age, never-smoking status, or low tobacco exposure. Compared to LCS-eligible patients, the LCS-ineligible group had a distinct profile characterized by a higher proportion of females, lung adenocarcinoma histology, and a greater frequency of actionable driver mutations (e.g., KRAS, EGFR). Notably, non-smoking LCS-ineligible patients had the highest prevalence of family history of cancer (FHC) at 82%, with frequent relatives affected by colorectal, breast, and lung cancers. Personal cancer history was also more common among LCS-ineligible patients.<br /><br />The study underlines that current LCS guidelines exclude a significant subset of lung cancer patients, particularly non-smokers and those with low tobacco exposure, who nonetheless demonstrate genetic and familial cancer risk factors. Incorporating familial and personal cancer history could help identify high-risk individuals otherwise missed by tobacco-centered screening programs. Further comprehensive characterization of these populations is underway in the ongoing LAPIN study (EU4H-2024-PJ-04) to potentially improve early detection strategies. This research supports expanding screening criteria to include non-smoking risk factors for better lung cancer mortality reduction.

Asset Subtitle

Juan Carlos Laguna

Meta Tag

Speaker Juan Carlos Laguna

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

non-small cell lung cancer

lung cancer screening

Nelson criteria

smoking history

familial cancer history

driver mutations

KRAS mutation

EGFR mutation

lung adenocarcinoma

early detection