至少10%的肺癌患者是从未吸烟的成年人。目前还没有明确的数据表明从未吸烟的成年人中肺癌的发生率是否在增加。肺癌的发病率是否随时间改变，特别是在从未吸烟的成年人中，我们进行了研究。我们利用从北加州一家综合医疗系统中的电子健康记录和癌症登记数据对一组有肺癌风险的30岁及以上的成年人进行了调查，时间跨度为2007年1月1日至2018年12月31日。我们估算了截断的年龄调整肺癌发病率和年均百分比变化（AAPC），并根据年龄、性别和种族/族裔分别对吸烟和不吸烟者进行了分析。 研究对象共计3,751,348名成年人（52.5%女性；48.0%非西班牙裔白人；63.1%从未吸烟），其中18,627例（52.7%女性；68.6%非西班牙裔白人；15.4%从未吸烟）被诊断为肺癌。整体肺癌发病率从2007-2009年的91.1下降到2016-2018年的63.7每10万人年（AAPC为-3.9%，95% CI为-4.2%，-3.6%）。在吸烟者中，发病率在所有年龄、性别和种族/族裔组中下降，从每10万人年的167.0降至113.4（AAPC为-4.2%，95% CI为-4.4%，-3.9%）。在从未吸烟的成年人中，发病率相对稳定，三年期估计值在19.9至22.6每10万人年之间（AAPC为0.9%，95% CI为-0.3%，2.1%）。除亚洲和太平洋岛民以外的种族/族裔组，从未吸烟的成年人的发病率随时间稳定，亚洲和太平洋岛民的发病率则是其他族裔的两倍左右（AAPC为2.0%，95% CI为0.1%，3.9%）。 这些观察结果强调了我们需要进一步阐明从未吸烟成年人罹患肺癌的病因，特别是为什么亚洲和太平洋岛民的发病率更高，且在不断上升的情况下。版权所有©2023，Elsevier Inc. 发表。

At least 10% of lung cancers arise in adults who have never smoked. Data remain inconclusive on whether lung cancer incidence has been increasing among never-smoking adults.How have age-adjusted incidence rates of lung cancer changed temporally, especially among never-smoking adults?Trends in lung cancer incidence were examined using linked electronic health record and cancer registry data on a dynamic cohort of adults aged ≥30 years at risk for incident lung cancer between 1/1/2007 and 12/31/2018 from an integrated healthcare system in northern California. Truncated age-adjusted lung cancer incidence rates and average annual percentage change (AAPC) in rates were estimated, overall and separately for ever- and never-smoking adults by age, sex, and race/ethnicity.Our cohort included 3,751,348 (52.5% female; 48.0% non-Hispanic White; 63.1% never-smoking) adults, among whom 18,627 (52.7% female; 68.6% non-Hispanic White; 15.4% never-smoking) were diagnosed with lung cancer. The overall lung cancer incidence rate declined from 91.1 to 63.7 per 100,000 person-years between 2007-2009 and 2016-2018 (AAPC, -3.9%; 95% CI, -4.2%, -3.6%). Among ever-smoking adults, incidence rates declined overall from 167.0 to 113.4 per 100,000 person-years (AAPC, -4.2%; 95% CI, -4.4%, -3.9%) and, to varying degrees, within all age, sex, and racial/ethnic groups. Among never-smoking adults, incidence rates were relatively constant, with three-year period estimates ranging from 19.9 to 22.6 per 100,000 person-years (AAPC, 0.9%; 95% CI, -0.3%, 2.1%). Incidence rates for never-smoking adults appeared stable over time within age, sex, and racial/ethnic groups, except for those of Asian and Pacific Islander (API) origin (AAPC, 2.0%; 95% CI, 0.1%, 3.9%), whose rates were about twice as high compared to their counterparts.These observed trends underscore the need to further elucidate the etiology of lung cancer in never-smoking adults, including why incidence is higher and rising in never-smoking API adults.Copyright © 2023. Published by Elsevier Inc.