Characterization of the cancer-associated field of injury in the nasal epithelium in never-smokers

Lung cancer in never-smokers represents a distinct and growing clinical challenge, yet early detection strategies largely target smokers. Here, we demonstrate that nasal epithelial gene expression alterations previously associated with lung cancer in current and former smokers are conserved in never-smokers. Notably, immune-related pathways, including interferon signaling, are similarly suppressed in malignant nodules in ever and never smokers. These findings suggest shared molecular mechanisms of lung carcinogenesis in ever and never smokers and should motivate validation of airway-based biomarkers in never-smoker populations.