Air pollution exposure in never-smokers is linked to increased DNA mutations in lung tumors, similar to smoking-related damage.
Higher pollution levels correlate with more driver mutations and accelerated cellular aging in lung cancer cells.
Secondhand smoke shows only minor mutational effects and significant telomere shortening in never-smokers.
Aristolochic acid from certain herbal medicines may contribute to lung cancer in never-smokers, especially in Taiwan.
A new, unknown mutational signature was found in most never-smoker lung cancers, indicating other unidentified risks.
Researchers plan to expand genomic studies to more regions and investigate other exposures like e-cigarettes and radon.
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