{"entity":{"id":"idea-prev-clean-air-never-smoker-endpoints","kind":"idea","name":"Evaluate clean-air policies using lung cancer in never-smokers","aka":[],"tldr":"Air pollution causes lung cancer in people who never smoked. Clean air zones and coal phase-outs should be tracked against never-smoker lung cancer rates.","summary":"Fine particulate pollution promotes EGFR-mutant lung cancer in never-smokers (Francis Crick Institute work). Propose linked-data evaluation of air-quality interventions (London ULEZ, Chinese coal-to-gas conversion) with never-smoker, EGFR-mutant lung cancer incidence as endpoints, and pre-registered modelling.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Prevention we already have is not deployed): Islami et al., Proportion of cancer attributable to modifiable risk factors (CA 2018)","url":"https://doi.org/10.3322/caac.21440"}],"tags":[],"related":["lung-cancer-evidence-roadmap","idea-lung-never-smoker-disease-its-own-programme"],"cancers":["nsclc"],"sections":["prevention"],"technologies":[],"targets":["egfr"],"drugs":[],"companies":[],"institutions":["francis-crick"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-prevention-adoption"],"keyPapers":["paper-islami-ca-cancer-j-clin"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A sustained 10 micrograms per cubic metre PM2.5 reduction reduces never-smoker lung cancer incidence by at least 10% within 15 years.","rationale":"Mechanistic and epidemiological evidence exists, and the policies are being enacted anyway, so evaluation is cheap.","test":"Registry-linked natural experiments with molecular subtyping.","maturity":"speculative","actor":"data","cost":"small","horizonYears":10},"route":"/ideas/idea-prev-clean-air-never-smoker-endpoints/","neighbours":{"roadmap":[{"id":"lung-cancer-evidence-roadmap","kind":"roadmap","name":"Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch","route":"/roadmaps/lung-cancer-evidence-roadmap/"}],"idea":[{"id":"idea-lung-never-smoker-disease-its-own-programme","kind":"idea","name":"Treat lung cancer in never-smokers as its own disease, with its own detection programme","route":"/ideas/idea-lung-never-smoker-disease-its-own-programme/"}],"cancer":[{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"target":[{"id":"egfr","kind":"target","name":"EGFR","route":"/targets/egfr/"}],"institution":[{"id":"francis-crick","kind":"institution","name":"The Francis Crick Institute","route":"/institutions/francis-crick/"}],"bottleneck":[{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"}],"paper":[{"id":"paper-doll-hill-smoking-lung-cancer-bmj-1950","kind":"paper","name":"Doll and Hill 1950: the case-control study that tied smoking to lung cancer","route":"/key-papers/paper-doll-hill-smoking-lung-cancer-bmj-1950/"},{"id":"paper-hill-lung-adenocarcinoma-air-pollutants-nature-2023","kind":"paper","name":"Lung adenocarcinoma promotion by air pollutants","route":"/key-papers/paper-hill-lung-adenocarcinoma-air-pollutants-nature-2023/"},{"id":"paper-islami-ca-cancer-j-clin","kind":"paper","name":"Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States","route":"/key-papers/paper-islami-ca-cancer-j-clin/"},{"id":"paper-tracerx-evolution-nature-2023","kind":"paper","name":"TRACERx 421: the full-cohort picture of how lung cancer evolves and which subclones drive relapse","route":"/key-papers/paper-tracerx-evolution-nature-2023/"}]}}