Lung Cancer

A risk factor is anything that increases a person’s chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed.

But having a risk factor, or even several, does not mean that you will get the disease. And some people who get the disease may have few or no known risk factors.

Several risk factors can make you more likely to develop lung cancer. These factors are related to the risk of lung cancer in general. It’s possible that some of these might not apply to small cell lung cancer (SCLC).

Risk factors you can change

Tobacco smoke

Smoking is by far the leading risk factor for lung cancer. About 80% of lung cancer deaths are thought to result from smoking, and this number is probably even higher for SCLC. It’s very rare for someone who has never smoked to have SCLC. 

The risk of lung cancer for people who smoke is many times higher than for people who don’t smoke. The longer you smoke and the more packs a day you smoke, the greater your risk.

Cigar smoking and pipe smoking are almost as likely to cause lung cancer as cigarette smoking. Smoking low-tar or “light” cigarettes increases lung cancer risk as much as regular cigarettes. Smoking menthol cigarettes might increase the risk even more since the menthol may allow people to inhale more deeply.

Secondhand smoke

If you don’t smoke, breathing in the smoke of others (called secondhand smoke or environmental tobacco smoke) can increase your risk of developing lung cancer.

Exposure to radon

Radon is a naturally occurring radioactive gas that results from the breakdown of uranium in soil and rocks. You can’t see, taste, or smell it. Radon is the second leading cause of lung cancer in this country, and it’s the leading cause among people who don’t smoke.

Outdoors, there is so little radon that it is not likely to be dangerous. But indoors, radon can be more concentrated. Breathing it in exposes your lungs to small amounts of radiation. This may increase a person’s risk of lung cancer.

Homes and other buildings in nearly any part of the United States can have high indoor radon levels (especially in basements).

Exposure to asbestos

People who work with asbestos (such as in mines, mills, textile plants, places where insulation is used, and shipyards) are several times more likely to die of lung cancer. Lung cancer risk is much greater in workers exposed to asbestos who also smoke. It’s not clear how much low-level or short-term exposure to asbestos might raise lung cancer risk.

People exposed to large amounts of asbestos also have a greater risk of developing mesothelioma, a type of cancer that starts in the pleura (the lining surrounding the lungs).

In recent years, government regulations have greatly reduced the use of asbestos in commercial and industrial products. It’s still present in many homes and other older buildings, but it’s not usually considered harmful as long as it’s not released into the air by deterioration, demolition, or renovation.

Exposure to other cancer-causing agents in the workplace

Other carcinogens (cancer-causing agents) found in some workplaces that can increase lung cancer risk include:

• Radioactive ores such as uranium
• Inhaled chemicals such as arsenic, beryllium, cadmium, silica, vinyl chloride, nickel compounds, chromium compounds, coal products, mustard gas, and chloromethyl ethers
• Diesel exhaust

The government and industry have taken steps in recent years to help protect workers from many of these exposures. But the dangers are still there, so if you work around these agents, be careful to limit your exposure whenever possible.

Taking certain dietary supplements

Studies looking at the possible role of vitamin supplements in reducing lung cancer risk have had disappointing results. In fact, 2 large studies found that people who smoked who took beta carotene supplements actually had an increased risk of lung cancer. The results of these studies suggest that people who smoke should avoid taking beta carotene supplements.

Arsenic in drinking water

Studies of people in parts of Southeast Asia and South America with high levels of arsenic in their drinking water have found a higher risk of lung cancer. In most of these studies, the levels of arsenic in the water were many times higher than those typically seen in the United States, even areas where arsenic levels are above normal. For most Americans who are on public water systems, drinking water is not a major source of arsenic.

Risk factors you cannot change

Previous radiation therapy to the lungs

People who have had radiation therapy to the chest for other cancers are at higher risk for lung cancer, particularly if they smoke. Examples include people who have been treated for Hodgkin disease or women who get chest radiation after a mastectomy for breast cancer. Women who have radiation therapy to the breast after a lumpectomy do not appear to have a higher than expected risk of lung cancer.

Air pollution

In cities, air pollution (especially near heavily trafficked roads) appears to raise the risk of lung cancer slightly. This risk is far less than the risk caused by smoking, but about 1% to 2% of all deaths from lung cancer in the US are thought to be due to outdoor air pollution.

Personal or family history of lung cancer

If you have had lung cancer, you have a higher risk of developing another lung cancer.

Brothers, sisters, and children of people who have had lung cancer may have a slightly higher risk of lung cancer themselves, especially if the relative was diagnosed at a younger age. It’s not clear how much of this risk might be due to shared genes among family members and how much might be from shared household exposures (such as tobacco smoke or radon).

Researchers have found that genetics seems to play a role in some families with a strong history of lung cancer.

Factors with uncertain or unproven effects on lung cancer risk

Smoking marijuana

There are reasons to think smoking marijuana might increase lung cancer risk.

• Marijuana smoke contains tar and many of same cancer-causing substances that are in tobacco smoke. (Tar is the sticky, solid material that remains after burning, which is thought to contain most of the harmful substances in smoke.)
• Marijuana cigarettes (joints) are typically smoked all the way to the end, where tar content is the highest.
• Marijuana is inhaled very deeply and the smoke is held in the lungs for a long time, which gives any cancer-causing substances more opportunity to deposit in the lungs.
• Because marijuana is still illegal in many places, it may not be possible to control what other substances it might contain.

Those who use marijuana tend to smoke fewer marijuana cigarettes in a day or week than the amount of tobacco used by people who smoke cigarettes. The lesser amount smoked would make it harder to see an impact on lung cancer risk.

It’s been hard to study whether there is a link between marijuana and lung cancer because marijuana has been illegal in many places for so long, and it’s not easy to gather information about the use of illegal drugs. Also, in studies that have looked at past marijuana use in people who had lung cancer, most of the people who smoked marijuana also smoked cigarettes. This can make it hard to know how much any increased risk is from tobacco and how much might be from marijuana. More research is needed to know the cancer risks from smoking marijuana.

E-cigarettes

E-cigarettes are a type of electronic nicotine delivery system. Most e-cigarettes contain nicotine, so the Food and Drug Administration (FDA) classifies them as “tobacco products.” E-cigarettes are fairly new, and more research is needed to know what the long-term effects might be, including any possible increased risk of developing lung cancer.

Talc and talcum powder

Talc is a mineral that in its natural form may contain asbestos. Some studies have suggested that talc miners and people who operate talc mills might have a higher risk of lung cancer and other respiratory diseases because of their exposure to industrial grade talc. But other studies have not found an increase in lung cancer rate.

Talcum powder is made from talc. The use of cosmetic talcum powder has not been found to increase lung cancer risk.