Lung Cancer In America 2019

Survey Finds Lung Cancer Patients Who Haven’t Used Tobacco Are Diagnosed at Later Stages, But Have Higher Quality of Life

—Findings from Health Union contribute to notion that lung cancer is misunderstood as only being smoking-related—

PHILADELPHIAJune 12, 2019 — A new survey from Health Union finds that whether a person with lung cancer has used tobacco can impact the patient journey, including the stage at which the person is diagnosed, knowledge about how the condition developed and quality of life. The survey, titled Lung Cancer In America 2019, illuminates the perspectives and experiences of people living with lung cancer.

Three in 10 survey respondents have never used any tobacco products, including cigarettes, e-cigarettes and chewing tobacco. Nearly nine in 10 do not currently use any tobacco products, while 9% still smoke and 3% vape. Unsurprisingly, respondents considered tobacco products their biggest risk factors for having lung cancer, with three-quarters citing smoking and 41% identifying exposure to secondhand smoke; risk factors not directly related to smoking included a family history of lung cancer (28%) and occupational exposure to carcinogens (13%).

With nearly all respondents who have used tobacco being current or former smokers, the misunderstanding that lung cancer is a “smoking disease” bears out in the results. Survey findings suggest that the absence of the most common risk factors – namely, smoking – potentially contributes to later diagnosis. Respondents who have never used tobacco – nearly two-thirds of them – were more likely than those who currently or previously used tobacco to initially be diagnosed at an advanced stage, which represents people at stage 3 or 4 for non-small cell lung cancer and extensive stage for small cell lung cancer. Additionally, they were more likely to seek out a second opinion at the time of diagnosis.

According to, advanced stage lung cancer – specifically stage 4 – can spread to both lungs, the fluid area around the lungs and other parts of the body, making treatment difficult. Half of non-tobacco-using Lung Cancer In America 2019 respondents still have advanced-stage diagnoses. While 36% of those who have used tobacco products currently have an advanced stage diagnosis, 37% said they currently have no evidence of the disease.

The survey findings also suggest people with lung cancer who have used tobacco typically don’t have much information about how their condition developed beyond their smoking history, which can potentially limit their treatment options. More than eight in 10 respondents who have used tobacco said they had either not been or weren’t sure about being tested for genetic mutations or rearrangements. Comparatively, more than half of those who have never used tobacco said they have been tested or remember being tested, with nearly a quarter being positive for an epidermal growth factor receptor, or EGFR, mutation.

Despite the confusion they often face when diagnosed, the survey supports the notion that people with lung cancer who have never used tobacco often have more positive quality of life, especially regarding relationships. Respondents who haven’t used tobacco were more likely to say they have a strong relationship with their friends, that their faith comforts them and that they find their work fulfilling. They were also more likely to say they look to other people they know with lung cancer and social media to learn about or help them manage their condition.

On the other hand, respondents who use or used tobacco were more likely to say they felt they can’t work and don’t find their sex lives satisfying. This adds to the strain of dealing with a bevy of other physical problems, potentially linked to their smoking history. These individuals were more likely than their counterparts who have never used tobacco to also be diagnosed with cardiovascular disease, chronic pain, COPD, hearing loss, high cholesterol, neuropathy and fibromyalgia.

“The Lung Cancer In America data supports the significant concern within the lung cancer community that the condition is often misunderstood and is always the result of smoking,” said Tim Armand, co-founder and president of Health Union. “This data shows how that misunderstanding – among potential patients, the clinical community and the general public – can have negative effects for people who both have and haven’t smoked. It also shows the importance of having a community, like, where people in any situation can share experiences.”

Lung Cancer In America 2019 surveyed 867 U.S. respondents diagnosed or in the process of being diagnosed with lung cancer, as well as 130 caregivers of current or deceased patients, from Jan. 7 to March 14, 2019. A summary infographic of the results is available on; additional survey results may be available upon request.

About Health Union

Health Union encourages social interactions that evolve into valuable online health conversations, helping people with chronic conditions find the information, connection and validation they seek. The company creates condition-specific online communities – publishing original, daily content and continuously cultivating social conversation – to support, educate and connect millions of people with challenging, chronic health concerns. Today, the Health Union family of brands includes 22 online health communities, including,, and