From smoking studies to precision medicine
Lung cancer was rare in 1900 but soared as cigarette smoking spread. In 1950 Richard Doll and Austin Bradford Hill in Britain, and Ernst Wynder and Evarts Graham in the U.S., reported a strong link between smoking and lung cancer, and the landmark 1964 Surgeon General's report made it official, launching modern tobacco control. In 2004 researchers found that tumors with EGFR mutations respond dramatically to targeted drugs; the 2011 National Lung Screening Trial showed low-dose CT screening cuts lung cancer deaths by 20%; and since 2015 immunotherapy has reshaped survival for advanced disease.
Causes and symptoms
About 80% of lung cancer deaths are tied to smoking, but secondhand smoke, radon (the leading cause among never-smokers), asbestos, air pollution, and family history matter too. Early disease is usually silent. Later signs include a cough that won't go away, coughing up blood, shortness of breath, chest pain, hoarseness, and weight loss. A cough lasting more than three weeks warrants a checkup to rule out cancer along with pneumonia or tuberculosis.
Screening and treatment
The USPSTF recommends a yearly low-dose CT for adults 50–80 with at least a 20 pack-year history who smoke now or quit within 15 years—yet fewer than 1 in 5 eligible Americans get screened. Non-small cell lung cancer (about 85%) caught early is often cured with minimally invasive surgery; small cell lung cancer spreads faster. For advanced cases, doctors test for mutations like EGFR and ALK to pick targeted pills, and otherwise combine immunotherapy with chemotherapy. Quitting smoking lowers risk at any age.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Does quitting really help?
- Yes—after about 10 years, lung cancer risk drops to roughly half that of people who keep smoking.
- Are e-cigarettes safe?
- Evidence that they're less harmful is limited, and long-term safety is unknown.
Sources reviewed: 2026-10-26
References
- Doll, R., & Hill, A. B. (1950). Smoking and carcinoma of the lung. BMJ, 2(4682), 739–748.
- National Lung Screening Trial Research Team. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. NEJM, 365(5), 395–409.
- Lynch, T. J., et al. (2004). Activating mutations in EGFR underlying responsiveness of non-small-cell lung cancer to gefitinib. NEJM, 350(21), 2129–2139.