You can get lung cancer in Delhi without smoking, warns shocking new study

As Delhi observes Lung Cancer Day, medical experts are drawing renewed attention to the city’s chronically poor air quality and its growing link to rising lung cancer cases — increasingly among non-smokers. The Asia Pacific Lung Cancer Policy Consensus (APAC Consensus), released this week, has highlighted air pollution as a major emerging risk factor across the region.

Non-smokers now forming a growing share of lung cancer patients

A 30-year study by the Centre for Chest Surgery at Sir Ganga Ram Hospital and Lung Care Foundation reveals a changing patient profile. In 1988, nearly 90% of lung cancer surgery patients were smokers. By 2018, that number had fallen to 50%. Among those under 50, 70% of surgical patients were non-smokers, and among patients below 30, none had a smoking history.

This shift has prompted experts to point to other environmental triggers. These include prolonged exposure to second-hand smoke, vehicular emissions, industrial pollutants, cooking oil vapours, and indoor fuels such as coal.

Doctors warn of public health emergency

Doctors across the city are raising concern about the alarming trend of younger, non-smoking individuals being diagnosed with lung cancer. Experts also point to possible links between pollution and genetic mutations like EGFR, which are more prevalent in Asian populations.

“We're seeing lung cancer in younger people, in women, in those without any history of smoking or family risk. The common thread is the toxic air,” said Shankar. “This isn't just an environmental issue, it's a public health emergency.”

As Delhi enters another season of hazardous air, doctors are warning that the connection between pollution and lung cancer is no longer avoidable. According to experts, the risk is now embedded in the very act of breathing.

Delhi’s air quality and shifting patient profiles

Lung cancer has become a significant public health concern in the capital, with its incidence and mortality rates steadily increasing, especially among men. According to the Delhi Cancer Registry, lung cancer accounted for 8.4% of all male cancer cases in 1988, rising to 10.6% by 2015. Among women, it grew from 1.9% to 3.4% in the same period.

Delhi’s air quality index frequently exceeds permissible limits — often by 8 to 10 times — contributing to a higher risk of respiratory illnesses. Nationally, lung cancer remains one of the leading causes of cancer-related deaths, with India accounting for 5.9% of global cancer cases and 8.1% of related deaths in 2020, according to the Journal of Thoracic Oncology.

Medical consensus and policy recommendations

Dr Abhishek Shankar, assistant professor of radiation oncology at AIIMS and India’s representative in the APAC Consensus, stated that the association between air pollution and lung cancer is now firmly established. “The link between air pollution and lung cancer is no longer a suspicion — it's a reality we're living with in Delhi,” he said.

The APAC Consensus document, developed by ASPIRE for Lung Cancer and regional stakeholders, recommends urgent action to broaden lung cancer risk definitions beyond smoking, improve early screening access, reduce stigma for non-smoker patients, and ensure equitable treatment availability. It also calls for stronger environmental regulations to reduce exposure to carcinogenic pollutants.

(With inputs from TOI)