From rare disease to new epidemic: Rethinking lung cancer’s causes

In this video, Jorge Nieva, M.D., professor of clinical medicine at the University of Southern California Norris Comprehensive Cancer Center, traces how lung cancer evolved from being a medical rarity in 1919 to an epidemic driven first by machine-rolled cigarettes. Although smoking rates fell sharply after the 1980s for both men and women, lung cancer declined mainly in men, suggesting a new carcinogen more common in women but still affecting men. Nieva’s environmental exposure study focused on patients diagnosed before age 50, whose cancers are usually driven by non–tobacco-related gene mutations. They found that these young patients tended to eat “healthier” diets, meaning more fruits, vegetables and whole grains, which are associated with higher pesticide residues, and that women, who are more likely than men to eat this way, are now overrepresented among young lung cancer patients.