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Lung Cancer in Non-Smokers, Telerad Tie-Up, and AI Safety Alliance
January 29, 2026
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Together with
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“No single AI can handle every task. The winning PACS will be the one that acts as a seamless ‘App Store,’ integrating various third-party algorithms into a single, unified user interface that manages ‘information overload’ without adding clicks.”
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Simon Häger, Fagerhult Group.
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Behind the growing enthusiasm for CT lung cancer screening is a nagging question – should we be screening people who have never smoked too? It’s a dilemma that’s addressed in a new paper in Radiology that offers some insight.
CT lung screening is the only major cancer screening test that’s exclusively targeted at high-risk individuals, essentially people who have smoked long enough to meet inclusion criteria.
- Other cancer screening exams – for breast, colorectal, and cervical cancer– are offered to broader segments of the population, with age typically the only qualifying factor.
But lung cancer still occurs in people who have never smoked, who account for 10-25% of lung cancer cases, the fifth most common cause of cancer mortality globally.
- For example, East Asian women, even those who have never smoked, seem to have higher lung cancer incidence rates, indicating a genetic risk factor that’s still not fully understood.
The new Radiology paper reviews the state of knowledge regarding lung cancer in people who have never smoked, and examines whether the phenomenon’s prevalence calls for a rethinking of how CT lung cancer screening is offered.
The authors explain that lung cancer in non-smokers…
- Can be caused by environmental factors like workplace exposure, air pollution, genetic susceptibility, and exposure to second-hand smoke (20-26% higher risk for spousal exposure).
- Has a different carcinogenesis mechanism than lung cancer in smokers, and tends to be more slow-growing.
- Has different characteristics than cancer in smokers, being overwhelmingly dominated by adenocarcinoma (90%).
So with this knowledge in hand, should current U.S. and European lung cancer screening guidelines be changed?
- Japan is already conducting mass lung screening regardless of smoking history, while China’s guidelines include people who have never smoked but have other risk factors like occupational exposure.
But broader screening could lead to higher rates of overdiagnosis and overtreatment, and early studies from Asia have found screening had little effect on overall mortality in non-smokers.
- That led the Radiology authors to conclude that, at present, it’s probably not advisable to begin screening people who have never smoked until more research is conducted.
The Takeaway
The new paper on CT lung cancer screening of people who have never smoked is more than just an interesting thought experiment. It surfaces an issue that’s been percolating as risk-based lung screening gains momentum, and that ultimately may require a completely different approach to lung screening from what’s been used to date.
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- Bayer to Highlight Gadoquatrane Progress: Bayer will highlight the progress being made in developing its gadoquatrane low-dose MRI contrast agent at ECR 2026 in March. Data from several Phase 3 subgroup trials will be presented, including safety and efficacy for abdominal and cardiac MRI and MR angiography, as well as data from Phase 2 and 3 trials for central nervous system imaging. The studies involve a gadoquatrane dose representing a 60% reduction compared to standard macrocyclic MRI agents.
- Tracking Incidental Pulmonary Nodules: Growing use of CT is leading to increased detection of incidental pulmonary nodules, which present follow-up challenges. Swedish researchers investigated the issue in Radiology by tracking 29.6k people in the SCAPIS study, finding a detection rate of 28% for small nodules and 4.8% for larger ones. Pulmonary nodule prevalence increased with age and smoking history, but follow-up was required for only 6.1% of cases, perhaps due to the relatively healthy study population with a high percentage of non-smokers.
- Partnership Boosts Lung Screening: Oncology workflow software company Azra AI partnered with CancerIQ to improve CT lung cancer screening and follow-up. The companies will integrate their solutions, with CancerIQ identifying patients who are eligible for screening while Azra AI helps manage follow-up and tracking of those with suspicious lung nodules. The integrated approach should help cancer programs develop sustained lung cancer screening services that go beyond one-time imaging events.
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- Harrison.ai’s India AI Installs: Harrison.ai continues to make inroads for its AI solutions in India. The company this week announced an agreement to install its chest X-ray image analysis and reporting solutions at Manipal Hospitals, which runs facilities in 24 cities that serve nearly 8M patients annually. In December, Harrison partnered with teleradiology provider Apollo Radiology International to deploy its chest X-ray and CT brain algorithms.
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