Smoking is nowhere near as popular as it was in decades past. The rate of U.S. adults who smoke has plummeted 74% since 1965 to 11.6% as of 2022, suggesting that the battle to get people to quit smoking (or never start) is all but won.
That should mean lung cancer rates have dropped accordingly, right? Overall, that’s true.
Since peaking in 1984, the rate of new cases of lung cancer (incidence) has decreased 42% among men. And since peaking in 1998, lung cancer incidence in women has decreased 16%.
So, while there has been an overall decline in lung cancer rates, it hasn’t been nearly as dramatic for women. And there is one group that has been an exception to the drop in lung cancer rates: nonsmokers age 50 and younger, especially women, who are now more likely to get lung cancer than men.
Weird thing is, this group seems to be doing one thing really well that experts say should help reduce cancer risk: eating healthy foods. But those foods aren’t the suspected problem — it’s the pesticides on them…
Lung cancer is rising in one unexpected group
New research from Keck Medicine of USC found that young nonsmokers with lung cancer reported eating more fruits, vegetables and whole grains than the average American. Researchers don’t believe these foods are inherently harmful. Instead, they’re investigating whether pesticide residues on commercially grown produce and grains could be one overlooked environmental factor in early-onset lung cancer.
The Epidemiology of Young Lung Cancer Project surveyed 187 patients diagnosed with lung cancer by age 50. Patients provided details on demographics, diet, smoking history and lung cancer diagnosis. Most of them had never smoked and had a form of lung cancer biologically different from the type of lung cancer caused by smoking.
Based on the Healthy Eating Index (HEI), a ranking of the overall quality of Americans’ diet on a scale of 1-100, the young nonsmoking lung cancer patients had healthier-than-average diet scores, coming in at 65, compared to the lower national average of 57.
They ate more daily servings of fruit, vegetables and whole grains than the general population, averaging 4.3 servings of dark green vegetables and legumes and 3.9 servings of whole grains each day. National averages are lower at 3.6 servings of dark green vegetables and legumes and 2.6 servings of whole grains per day.
Among study participants, women had higher HEI scores than men and tended to have diets higher in produce and whole grains. The study also showed that young women who don’t smoke have a higher incidence of lung cancer than men.
Could pesticides be the missing link?
So, if the young nonsmoking lung cancer patients were eating healthier than the average American, why were they getting lung cancer?
The researchers have a theory, and it’s deeply troubling: they speculate the risk factor may be the pesticides used on commercially produced (non-organic) produce and whole grains.
Commercially produced fruits, vegetables and whole grains are more likely to be associated with a residue of pesticides than dairy, meat and many processed foods, according to Dr. Jorge Nieva, a medical oncologist and lung cancer specialist with USC Norris Comprehensive Cancer Center and lead investigator of the study.
Nieva also notes that agricultural workers exposed to pesticides typically have higher rates of lung cancer, which adds credibility to the theory.
“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,” he says. “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.”
The link between pesticides and lung cancer in young people, especially women, needs more research, Nieva adds. For instance, in the study, researchers didn’t test specific foods for pesticides, relying instead on published data on average pesticide levels for food categories such as fruits, vegetables and grains to estimate exposure.
The next step, according to Nieva, is to confirm the link by directly measuring pesticide levels in blood or urine samples. This could also help reveal whether some pesticides increase lung cancer risk more than others.
“This work represents a critical step toward identifying modifiable environmental factors that may contribute to lung cancer in young adults,” Nieva says. “Our hope is that these insights can guide both public health recommendations and future investigation into lung cancer prevention.”
How to reduce pesticide exposure without giving up healthy foods
You don’t need to stop eating fruits, vegetables or whole grains. But if pesticide exposure is a concern, you can take a few practical steps:
- Wash produce under running water before eating or cooking.
- Peel fruits and vegetables when appropriate, though this can reduce some nutrients and fiber.
- Choose organic versions of foods you eat most often, or use The Dirty Dozen List to prioritize which foods to buy organic, since buying all your produce organic can be more costly. Strictly eating organic food has been shown to reduce pesticide levels measured in urine within a very short period of time.
- Vary your produce and grains instead of relying heavily on the same few foods every day.
- Take steps to reduce exposure to environmental cancer risks that are linked to lung cancer as well.
FAQ: Healthy Foods and Lung Cancer
This study does not prove that fruits and vegetables cause lung cancer. Researchers found that young nonsmokers with lung cancer reported eating more fruits, vegetables and whole grains than the average American, and they are investigating whether pesticide residues may help explain the pattern.
No. These foods are still important for overall health. The concern raised by this research is not the foods themselves, but possible pesticide exposure from some commercially grown foods.
This study did not test whether eating organic foods lowers lung cancer risk. However, choosing organic versions of some foods may help reduce exposure to certain synthetic pesticide residues.
The study surveyed 187 people who were diagnosed with lung cancer by age 50. Most had never smoked, and many had a form of lung cancer that differed biologically from smoking-related lung cancer.
Sources:
1. Eating fruits, vegetables and whole grains may increase chance of early onset lung cancer — Keck Medicine of USC
2. 5039 / 12 – Dietary patterns in young lung cancer: mutation-specific environmental associations — AACR Annual Meeting 2026 San Diego
3. Overall Smoking Trends — American Lung Association
4. Lung Cancer Trends Brief: Prevalence and Incidence — American Lung Association