Dietary patterns in young patients with lung cancer suggest that many have higher dietary quality scores than average U.S. reference values, according to results from a study presented at the American Association for Cancer Research (AACR) Annual Meeting 2026 (Abstract 5039). The researchers suggested that incidence of lung cancer in younger, nonsmoking patients with a healthy diet could possibly be connected with pesticide/herbicide contaminants in produce-based whole foods.
“Our research shows that younger nonsmokers who eat a higher quantity of healthy foods than the general population are more likely to develop lung cancer,” said lead study investigator Jorge Nieva, MD, a medical oncologist and lung cancer specialist at the USC Norris Comprehensive Cancer Center. “These counterintuitive findings raise important questions about an unknown environmental risk factor for lung cancer related to otherwise beneficial food that needs to be addressed.”
Background and Study Methods
There has been an increase in lung cancer incidence among younger patients, especially women. Researchers sought to learn about potential drivers of this change through an epidemiological study of young patients with lung cancer.
The investigators analyzed 187 patients (84% female) from the Epidemiology of Young Lung Cancer study. Patients were grouped by shared biological mechanisms of gene alterations: EGFR pathway (EGFR, ERBB2), fusion-positive (ALK, ROS1, RET, NTRK), and other/mixed mutations (including MET exon 14 skipping, TP53, KRAS, BRAF, and other alterations).
A total of 166 patients completed validated food frequency questionnaires for analysis of their dietary quality, which was determined in alignment with the Healthy Eating Index-2015 and U.S. references values from the National Health and Nutrition Examination Survey.
Key Findings
Among young patients with lung cancer with EGFR pathway mutations, individuals had a dietary quality score of 64.9 ± 10.7 (out of 100), 65.5 ± 9.8 (out of 100) for fusion-positive alterations and 63.5 ± 9.5 (out of 100) for other/mixed mutations; the U.S. reference value is 58.
Dietary quality scores were higher among young women with lung cancer than in young men (65.6 ± 9.7 vs 61.8 ± 11.3), though both were above U.S. reference values of 60 and 56, respectively.
Young patients with lung cancer were more likely to consume foods associated with elevated contaminant exposure potential, including vegetables (4.2 vs 3.5), fruits (3.3 vs 2.5), and whole grains (3.9 vs 2.6).
“This work represents a critical step toward identifying modifiable environmental factors that may contribute to lung cancer in young adults," said Dr. Nieva. “Our hope is that these insights can guide both public health recommendations and future investigation into lung cancer prevention.”
DISCLOSURES: For full disclosures of the study authors, visit abstractsonline.com.
