Key takeaways

  • EGFR-positive lung cancer is more common in non-smokers (particularly those with adenocarcinoma) and younger adults, as it often develops from a single genetic mutation rather than widespread DNA damage associated with smoking.
  • Women are diagnosed with this type of lung cancer more often than men, possibly due to the influence of estrogen on lung tissue and EGFR pathways.
  • People of Asian descent have a higher rate of EGFR-positive lung cancer compared to people in Western countries, with genetic and environmental factors likely contributing to this difference.

Epidermal growth factor receptor (EGFR)-positive lung cancer is a type of non-small cell lung cancer (NSCLC). It’s caused by a genetic mutation in the EGFR gene. This mutation keeps the EGFR receptor switched “on,” leading to uncontrolled cell growth and enhanced cancer cell survival.

Anyone of any age can be diagnosed with EGFR-positive lung cancer, but it affects some populations more than others. More research is needed to fully understand why that is, though experts believe a combination of factors, including genetics, lifestyle, hormones, and environmental exposures, may play a role.

EGFR-positive lung cancer is more common among people who have never smoked or who have smoked very little.

This relates to how lung cancer develops. For most people, NSCLC is linked to smoking, as it exposes your lungs to harmful chemicals that cause inflammation and widespread DNA damage. In these cases, lung cancer is often driven by multiple genetic changes.

By contrast, if you’ve never smoked, lung cancer is more likely to result from a single mutation, such as an EGFR mutation. While EGFR mutations can still occur in people with a history of smoking, they are less common, as smoking creates an environment that is more likely to drive the development of other cancer-related mutations.

Adenocarcinoma is a common type of NSCLC and is the most common type of lung cancer diagnosed in people with little or no history of smoking.

Adenocarcinomas are more likely than other types of NSCLC to be EGFR-positive. This is because adenocarcinoma develops from glandular epithelial cells in the lungs, which naturally express higher levels of EGFR and rely on EGFR signaling for growth and repair.

Women are more likely than men to develop EFGR-positive lung cancer. In the EARLY-EGFR study, 64% of women with early-stage lung cancer had an EGFR mutation compared with 36.4% of men.

The reasons for this difference are not fully understood, but theories point to estrogen signaling as a possible factor. Lung tissue contains estrogen receptors, and estrogen can activate EGFR pathways, increase EGFR expression, and create a cellular environment that may support the growth of EGFR-mutated cells.

Lifestyle factors could also play a role. Men are more likely than women to smoke cigarettes, and smoking causes widespread DNA damage. In these cases, EGFR mutations are less likely to be the primary driver of lung cancer.

For most people, EGFR mutations are not inherited. They occur during your lifetime and can arise due to a variety of reasons.

While people of any age can be diagnosed with EGFR-positive lung cancer, it’s more common in adults who are 55 or younger. In fact, EGFR-positive lung cancer accounts for up to 50% of lung cancers in this age group.

One reason EGFR-positive lung cancer is more common in younger adults is that it can develop from a single activating mutation and does not require long-term exposure to toxins, unlike smoking-related cancers.

Research also suggests that lifestyle factors, environmental exposures, and in some cases, inherited genetic predispositions may contribute to the higher rates of EGFR-positive lung cancer seen in younger adults.

People of Asian ethnicity have a higher rate of EGFR-positive lung cancer compared to Western populations.

A 2021 meta-analysis found that the prevalence of EFGR-positive cancer (primarily adenocarcinoma) in Asian countries was 49.1%, compared to 12.8% in European countries. The 2024 EARLY-EGFR study reported similar numbers, with the highest EGFR mutation rates in Singapore.

The reasons for this disparity are not fully understood. Experts suggest that genetic, environmental, and evolutionary factors unique to different regions may play a role.

For example, while most EFGR mutations are not inherited, other genes passed down through families might increase the likelihood of developing an EFGR mutation. In some populations, these genes may be more common, contributing to higher rates of EGFR-positive lung cancer.

EFGR-positive lung cancer can affect anyone, but some people may have a higher risk of receiving this diagnosis.

Women, younger adults, people of Asian ethnicity, and those living with adenocarcinoma are disproportionately affected by EGFR-positive lung cancer.

While there are different reasons behind these disparities, most risk factors for EGFR-positive lung cancer are linked to a complex mixture of predisposing genetics, environmental factors, and individual biology.