The absence of tobacco use suggests alternative carcinogenic mechanisms may contribute to lung cancer development in younger individuals.
SAN CARLOS, Calif., April 17, 2026 — The Addario Lung Cancer Medical Institute (ALCMI) and GO2 for Lung Cancer today announced results from a new study presented at the 2026 American Association for Cancer Research annual meeting showing that lifestyle patterns and dietary exposures could play a role in tumor mutations among young adults with lung cancer. The results, drawn from the ongoing Epidemiology of Young Lung Cancer study, may help uncover modifiable risk factors in a population where lifestyle behaviors traditionally associated with lung cancer, such as smoking, fail to explain disease onset.
This project is conducted by researchers from California Northstate University College of Medicine, the Dana-Farber Cancer Institute, The Ohio State University Comprehensive Cancer Center, and USC Norris Comprehensive Cancer Center, part of Keck Medicine of USC. The work is supported by AstraZeneca, the Beth Longwell Foundation, Genentech, GO2 for Lung Cancer, and Upstage Lung Cancer.
There is growing concern that lung cancer is biologically distinct in adults under 40, with 84% of patients carrying targetable mutations. These historically younger patients are predominantly female and never-smokers, which raises questions about other potential environmental contributors.
The new analysis examined data from 187 patients, assessing dietary patterns and food exposure in conjunction with mutation subtypes. Key findings include:
—Diet quality and pesticide-linked foods. Patients with EGFR and fusion mutations reported better overall diet quality than the U.S. population average. However, their higher intake of fruits, vegetables, and whole grains, which are often associated with elevated pesticide residue, may represent an overlooked environmental risk factor.
—Unexpected tobacco associations. In the fusion pathway group (ALK, ROS1, RET, NTRK), 55.6% were never-smokers, challenging conventional links between these mutations and tobacco exposure. Conversely, one-third of EGFR pathway patients reported a smoking history, higher than anticipated.
—Potential connection to oral contraceptives. Oral contraceptive use was consistently elevated across all biological pathway groups. Although most patients reported 1-5 years of use, the median duration was 10 years due to a subset of long-term users. This matters because the pesticides can act as endocrine disruptors that interact with estrogen receptors seen in the lung cancers most prevalent in the young lung cancer population.
The study team notes that further research is needed to clarify how dietary pesticide exposure interacts with genetic pathways and whether reducing exposure could lower risk.
“These findings demonstrate that there is still so much to learn about this terrible disease, particularly as it occurs in young people,” said ALCMI Executive Director and COO Richard Erwin. “Our hope is that this is just the beginning of this research and that others will join us in exploring how and why lung cancer is presenting in the younger patient population.”
“This work represents a critical step toward identifying modifiable environmental factors that may contribute to lung cancer in younger adults,” said Jorge J. Nieva, MD, a thoracic oncologist with USC Norris Comprehensive Cancer Center. “Our hope is that these insights can guide both public health recommendations and future research into prevention.”
“Too many young people diagnosed with lung cancer are left asking, ‘how did this happen?’ especially when they have no known risk factors,” said Chief Patient Officer and Co-Interim CEO of GO2 for Lung Cancer Danielle Hicks. “This research reflects what patients have long suspected. There may be risk factors beyond their control. It’s a critical step toward understanding risk, improving early detection, and giving patients clearer answers.”
These findings would not be possible without the vision of ALCMI Co-Founder Bonnie J. Addario, who passed away in 2025. She long suspected an unknown environmental link could be contributing to this disease and was steadfast in her determination to search for answers for lung cancer patients.
“While more research is needed to confirm these findings, this is the first clear evidence that lung cancer in younger patients may develop through a different biological pathway,” said Tony Addario, ALCMI co-founder and husband of the late Bonnie Addario. “This discovery is both scientific and deeply personal. Bonnie’s vision has guided this research from the very beginning, and her legacy continues in the hope we bring to every person facing lung cancer, and in the lives we may one day prevent from ever being touched by it.”
Disclosure:
Dr. Nieva has received consulting payments from AstraZeneca and Genentech.
About ALCMI and GO2 for Lung Cancer
GO2 for Lung Cancer (GO2) and the Addario Lung Cancer Medical Institute (ALCMI) are strategic partners that drive innovative, patient-centered research across the lung cancer care continuum. By combining GO2’s expertise and trusted patient relationships with ALCMI’s robust clinical research capabilities, we make it easier to recruit and enroll patients into our decentralized clinical trials. This unique partnership accelerates smarter, faster, and more impactful science—unmatched in the field of lung cancer research.
Contact:
Wayne Niemi
Addario Lung Cancer Medical Institute
wniemi@alcmi.org
