How Genetic Mutations Affect Your Lung Cancer Risk
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Is Lung Cancer Hereditary?

Is Lung Cancer Hereditary?
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Published on June 28, 2025
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A lung cancer diagnosis can feel frightening. And when a family member is diagnosed, you might wonder about your own risk, prompting you to ask if lung cancer is hereditary.

Smoking tobacco accounts for 80 percent of all lung cancers.

 But research has found that genetic mutations and inherited genes may play a part in the development of lung cancer.

 However, only 8 percent of lung cancer cases are attributed to hereditary factors, according to research.

Even if a family member has lung cancer, that doesn’t mean you will get it, too. Genetics can play a part, but other risk factors hold more sway.

The Genetics of Lung Cancer

DNA gives your cells instructions based on the order of its nucleotides. When these building blocks are out of sequence or damaged, a gene mutation may be created.

 Mutations in lung cells can cause an overgrowth of cells that turn into cancer.

“These mutations can keep lung cells from responding to cues that normally would control their growth and survival,” says Katerina Politi, PhD, a researcher and the scientific director of the Center for Thoracic Cancers at Yale Cancer Center in New Haven, Connecticut.

The body doesn't always inherit gene mutations. It can also acquire them. Inherited mutations come from the DNA you got from your parents, while acquired mutations happen randomly or due to exposure to radiation and chemicals.

 Mutations can also affect different genes, such as the Kirsten rat sarcoma virus (KRAS) and epidermal growth factor receptor (EGFR) genes. These mutations are often called biomarkers.

KRAS Mutations in Lung Cancer

KRAS genes typically receive and send information that leads to cell growth, and a mutation can mean that cells grow too much, developing into cancer.

 The KRAS mutation in lung cancer is one of the most common, especially in adenocarcinoma, a type of non-small cell lung cancer.
About 25 percent of all patients diagnosed with lung cancer have a KRAS mutation, a number that goes up to 30 percent for lung adenocarcinomas.

“KRAS mutations are associated with more aggressive tumor behavior and resistance to standard therapies,” says Michael Menefee, MD, a medical oncologist at the Cleveland Clinic in Ohio.

Depending on the stage at diagnosis, the survival rate could be anywhere from eight months to four years, according to research.

 Treatment has advanced for some KRAS mutation types, however.

Approved treatments for KRAS-positive lung cancer include these methods:

Two KRAS inhibitors, a type of targeted therapy, are approved for patients with the KRAS G12C mutations:

  • sotorasib (Lumakras)
  • adagrasib (Krazati)

The G12C mutation is the most common KRAS mutation among people with lung cancer, Dr. Menefee says, adding that “there are additional mutations in KRAS for which novel therapies are being developed.”

EGFR Mutations in Lung Cancer

The EGFR gene helps cells grow and multiply. When it mutates, it can promote abnormal cell growth.

Overall, EGFR mutations appear in about 10 to 15 percent of lung cancers diagnosed in the United States, and researchers estimate that nonsmokers with the EGFR mutation have about a 30 percent chance of developing lung cancer.


EGFR-related lung cancer is more common in these groups:

  • People who have never smoked
  • People assigned female at birth
  • People with adenocarcinoma
  • Young adults with lung cancer
  • People of Asian descent

“There are different types of EGFR mutations, some of which impact prognosis and therapeutic decisions,” Menefee says.

Management and treatment of this mutation has advanced in recent years, he says. Treatment may include these options:

  • EGFR inhibitors such as osimertinib (Tagrisso), afatinib (Gilotrif), erlotinib (Tarceva), and lazertinib (Lazcluze)

  • Antibody-based targeted therapy such as amivantamab (Rybrevant)

  • Combination therapies such as chemotherapy with osimertinib, or lazertinib with amivantamab

Should You Get Lung Cancer Screening?

Experts recommend annual lung cancer screening for anyone who meets all three criteria:

  • 50 to 80 years old
  • A smoking history of 20 packs per year, meaning a pack of cigarettes daily for 20 years or two packs a day for 10 years
  • Current smoker or person who quit in the past 15 years
A family history of lung cancer may prompt your provider to recommend cancer screening. Research has shown that immediate, or first-degree, nonsmoking relatives of people who had lung cancer are more likely than other nonsmokers to get lung cancer.

“In addition, if a first-degree relative had lung cancer at a particularly young age — 50 or younger — consideration for screening should be considered on a case-by-case basis,” Menefee says.

Genetic Testing for Lung Cancer

There are no official recommendations for genetic testing for lung cancer. But some hospitals offer genetic counseling to aid in early diagnosis, staging, and treatment decisions.

Healthcare providers can look for genetic mutations with these tests:

  • Next-Generation Sequencing Doctors take tissue from a tumor via a biopsy and analyze it to find mutations.
  • Liquid Biopsy Doctors analyze blood to check for biomarkers, including mutations.
These tests can help doctors determine if you have genetic mutations such as EGFR or KRAS. They can also identify the specific mutation, which can inform how best to treat you.

Lowering Risk

Although lung cancer can be carried down through genes in less than 10 percent of cases, smoking still puts you at greater risk. Other important risk factors include exposure to radon and asbestos.

Radon, a natural gas that comes from soil and rocks, is the second leading cause of lung cancer in the United States. Asbestos was used in insulation and other products until 1989.

 If you work with this material, it can increase your risk of lung cancer, especially if you also smoke.

Even if lung cancer runs in your family, you can lower your risk by taking these steps:

  • Stop smoking.
  • Avoid secondhand smoke.
  • Test your home for radon.
  • Reduce high radon levels in your home with better ventilation.
  • Follow all health and safety guidelines at your workplace.

The Takeaway

  • Lung cancer can be hereditary if you have gene mutations such as KRAS or EGFR, which increase your risk.
  • The biggest risk factor for lung cancer is smoking, which causes 80 percent of all lung cancers; 8 percent of lung cancers are linked to hereditary factors.
  • New treatments target KRAS and EGFR mutations, and more research is underway to find targeted therapies for all mutation types.
  • You can lower your lung cancer risk if you stop smoking, avoid secondhand smoke, and lessen your exposure to harmful substances such as radon and asbestos.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  6. Gene Changes and Cancer. American Cancer Society. February 20, 2025.
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  9. Thomas QD et al. Clinical Characteristic and Survival Outcomes of Patients With Advanced NSCLC According to KRAS Mutational Status in the French Real-Life ESME Cohort. ESMO Open. June 2024.
  10. EGFR. Lung Cancer Foundation of America.
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  15. Targeted Therapies. Lung Cancer Foundation of America.
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Conor Steuer, MD

Medical Reviewer
Castle Connolly Top Doctor

Conor E. Steuer, MD, is medical oncologist specializing in the care of aerodigestive cancers, mesothelioma, and thymic malignancies and an assistant professor in the department of hematology and medical oncology at the Emory University School of Medicine in Atlanta. He joined the clinical staff at Emory's Winship Cancer Institute as a practicing physician in July 2015. He currently serves as chair of the Lung and Aerodigestive Malignancies Working Group and is a member of the Discovery and Developmental Therapeutics Research Program at Winship.

Dr. Steuer received his medical degree from the New York University School of Medicine in 2009. He completed his postdoctoral training as a fellow in the department of hematology and medical oncology at the Emory University School of Medicine, where he was chief fellow in his final year.

He has been active in research including in clinical trial development, database analyses, and investigation of molecular biomarkers. He is interested in investigating the molecular biology and genomics of thoracic and head and neck tumors in order to be able to further the care of these patient populations. Additionally, he has taken an interest in utilizing national databases to perform clinical outcomes research, as well as further investigate rare forms of thoracic cancers.

Steuer's work has been published in many leading journals, such as Cancer, the Journal of Thoracic Oncology, and Lung Cancer, and has been presented at multiple international conferences.

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Abby McCoy, RN

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.

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