. The Pope’s diagnosis should change how Africa thinks about lung cancer, and about TB
By Caleb Egwuenu
A diagnosis that should change how we think
On Tuesday, 13 October 2026, surgeons at Rome’s Gemelli hospital removed the lower lobe of Pope Leo XIV’s right lung. The Vatican then confirmed what the tissue showed: the 71-year-old pontiff has lung adenocarcinoma, the most common form of lung cancer.
The nodule was found early, during routine medical tests, and was well localised. And Pope Leo is not known to have ever been a smoker.
That last fact matters more than any other this November, Lung Cancer Awareness Month. It breaks the most dangerous myth about this disease: that it only happens to smokers. The truth is simpler and harder. If you have lungs, you can get lung cancer.
Not just a smoker’s disease
Smoking remains the leading cause of lung cancer, and quitting is still the best thing a smoker can do for their lungs. But as many as 1 in 5 lung cancers occur in people who have never smoked.
The World Health Organization’s cancer agency, IARC, now ranks lung cancer in never-smokers as the fifth highest cause of cancer deaths worldwide. In never-smokers it appears almost always as adenocarcinoma, the same type the Pope has.
Adenocarcinoma is now the most common lung cancer worldwide. In 2022 it made up 45.6% of cases in men and 59.7% in women. As one MD Anderson oncologist put it, “the face of lung cancer is changing”: more women, more younger people, more people who never touched a cigarette.
What else is in the air we breathe
IARC estimates that about 200,000 adenocarcinoma cases in 2022 were linked to outdoor air pollution alone. The American Cancer Society also lists radon gas, asbestos, radiation and secondhand smoke as risks.
For many Africans, the most dangerous air is inside the home. Around 2.1 billion people still cook over open fires or inefficient stoves burning wood, charcoal, dung, crop waste or kerosene. In sub-Saharan Africa, 923 million people lacked access to clean cooking in 2022.
In a poorly ventilated kitchen, smoke can carry fine particles at 100 times acceptable levels. WHO lists lung cancer among the diseases this causes, and women and children carry the heaviest burden because they spend the most time by the fire.
Add the exhaust from generators and old vehicles, dust from mines and quarries, open burning of waste, and asbestos roofing still found in older buildings. A grandmother who has never smoked a day in her life may have breathed more smoke than many smokers.
Africa’s blind spot: when cancer is treated as TB
In Africa, a persistent cough, weight loss, chest pain or coughing blood usually points one way: tuberculosis. In countries with some of the world’s heaviest TB burdens, Nigeria among them, that instinct often saves lives. It also hides lung cancer in plain sight.
The two diseases look alike on a chest X-ray and in the clinic. A patient is started on six months of TB drugs. When they do not improve, the treatment is often restarted. Months pass before anyone asks for a CT scan or a biopsy.
A study at Zimbabwe’s largest cancer centre shows the cost. Among 73 patients with confirmed lung cancer:
· 53% had been diagnosed with pulmonary TB in the year before their cancer was found
· the median delay to a cancer diagnosis was more than eight months, and up to three years
· only 15% were diagnosed within three months of first seeking care
· 77% had stage IV cancer, already spread, by the time it was found.
The authors’ conclusion is blunt: most lung cancer patients there were first misdiagnosed as having TB. The same study notes that only 1% of the world’s recorded lung cancer deaths are reported from Africa. That figure says less about how rare the disease is here than about how rarely we look for it.
Compare that with the Pope. His nodule was found early, on a routine test, and removed within days. Most African patients never get that chance.
What must change
Lung cancer is very treatable when caught early. Surgery, as in the Pope’s case, can remove it completely. The difference between a cure and a late diagnosis is often whether someone thought to look.
For health workers : if a patient on TB treatment is not getting better, or their sputum tests keep coming back negative, think cancer. Refer for a CT scan and a biopsy instead of restarting the same drugs.
For governments: build lung cancer into TB programmes, which already reach patients with chest symptoms. Fund CT scanners, pathology and thoracic surgery in more than a handful of cities. Speed up access to clean cooking fuel and enforce clean-air rules.
For families and communities: usea cough lasting more than three weeks, coughing blood, chest pain, hoarseness or unexplained weight loss needs a proper check, whether or not the person smokes. Ask the doctor directly: could this be cancer? Cook outdoors or in well-ventilated spaces where you can, and keep children away from smoke.
For all of us: drop the stigma. A lung cancer patient is not someone who “brought it on themselves”. They could be a market woman, a miner, a teacher, a child of a cook, or a Pope.
This November, Move Against Cancer Africa (MACA) asks every reader to remember one sentence and pass it on. If you have lungs, you can get lung cancer. Knowing that could save a life.
*Caleb Egwuenu is Executive Director of Move Against Cancer Africa (MACA), a pan-African cancer non-profit, and Deputy Chair of the IASLC Patient Advocacy Committee.