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1
USPSTF screening criteria cover adults aged 50 to 80 years with at least 20 pack-years, but exclude many people who develop lung cancer, including never-smokers.
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2
In prediagnostic samples from never-smokers, each SD increase in CEACAM5 and CEACAM6 was associated with 65% and 72% higher lung cancer risk within 5 years.
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3
Associations for CEACAM5 and CEACAM6 were replicated in 49,291 UK Biobank participants, with corresponding risk increases of 86% and 92%.
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4
Most markers previously linked to imminent smoking-related lung cancer were not associated with lung cancer in never-smokers, indicating that smoking-based risk models cannot be extrapolated to them.
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5
Risk-based selection is needed before offering LDCT to never-smokers, and CEACAM5 and CEACAM6 require evaluation alongside other risk factors in a calibrated risk model.
