A San Francisco hospital is pairing lung cancer screening with mammogram visits in a bid to catch tumors earlier in women who would otherwise never qualify for a scan, including women who have never smoked a cigarette in their lives. The initiative, called Grouped Lung Cancer and Mammography Screening, or GLAMS, began expanding this month at Sutter Health CPMC's Breast Health Center on the hospital's Pacific Heights outpatient campus.
The program is the work of Dr. Heba Ismail, a pulmonary specialist and director of CPMC's Lung Nodule Center, who leads the GLAMS initiative, according to the San Francisco Chronicle. Ismail has described lung cancer in nonsmoking women as a growing and under-recognized problem, per the same report by Chronicle health reporter Catherine Ho. GLAMS began as a pilot more than a year before publication and had already screened about 100 patients during that period, the Chronicle reported, before expanding this month into its first formal study phase.
In that first phase, mammogram patients who already meet current national screening guidelines are being offered the option of a lung cancer scan during the same visit, with those CT scans covered by insurance, per the Chronicle's reporting. A second phase, expected to launch in early 2027, would extend CT scans to mammogram patients who fall outside standard guidelines but carry study-defined risk factors — with those scans paid for through philanthropic donations. CPMC has secured funding to cover up to 1,000 qualifying women, according to the same account.
A Patient Whose Cancer Came Back Nine Years Later
The Chronicle's story centers on Jennifer Morrice, a San Francisco resident who was diagnosed with stage 3 lung cancer at age 45 despite never having smoked. Morrice was diagnosed 11 years before publication after visiting an emergency room with stomach pain; doctors found tumors in her left lung that likely pressed on nerves and caused the abdominal pain, the Chronicle reported. She underwent surgery to remove her left lung along with chemotherapy and radiation, and reached no-evidence-of-disease status for nine years.
Then in 2024, Morrice discovered a new cancer growth, this time in her right lung. She has ALK-positive lung cancer, a form that can result from changes in the ALK gene, and now takes oral medication meant to shrink cancer spots and prevent their growth, according to the Chronicle. Morrice has said her diagnosis felt unexpected because she had no symptoms beforehand, and she now serves on the board of the American Lung Association's Bay Area chapter and encourages eligible women to take part in GLAMS, per the same reporting.
Why Standard Guidelines Miss Many Women
National screening guidelines recommend annual low-dose CT scans for adults ages 50 to 80 with a 20-pack-year smoking history who currently smoke or quit within the past 15 years. The U.S. Preventive Services Task Force recommends annual low-dose CT screening for adults ages 50 to 80 with a 20-pack-year smoking history who currently smoke or quit within the past 15 years, having expanded eligibility in recent years from a 55-to-80 age range and a 30-pack-year threshold. The task force also lists environmental exposures, prior radiation therapy, other noncancer lung diseases and family history as additional risk factors beyond smoking.
Lung cancer remains the leading cause of cancer deaths in the United States, and research suggests genetics and environmental exposures contribute to a higher risk of the disease in women, according to the Chronicle. Women, especially those of Asian descent, represent a disproportionately large share of lung cancer cases among people who have never smoked, the paper reported, and women of Asian descent are more likely to carry an EGFR gene mutation that may be triggered by environmental toxins. The CDC estimates that 10% to 20% of lung cancers in the U.S. — roughly 20,000 to 40,000 cases a year — occur in people who never smoked or smoked fewer than 100 cigarettes in their lifetime.
Risk Factors the GLAMS Study Is Tracking
The GLAMS study is screening for a range of risk factors beyond smoking history, including family history of lung cancer, exposure to radon, asbestos or secondhand smoke, Asian ancestry, a history of chronic lung disease or previous cancer, and a history of hormone replacement therapy, per the Chronicle's reporting. Secondhand smoke, asbestos, radon and wood-fire smoke can all raise lung cancer risk in nonsmokers when exposure levels are high, while hormone replacement therapy has a less certain association with the disease, the paper noted. A nurse navigator within the program helps patients work through whether they may have experienced environmental toxin exposure, according to the same account.
The gap GLAMS is trying to close shows up starkly in national screening data. Only 5% of people eligible for lung cancer screening actually receive the recommended imaging, compared with 72% of women eligible for mammograms who get screened regularly, according to a Stanford Medicine report — even though lung cancer kills around 50% more women than breast cancer each year in the U.S. Stanford researchers tested a similar pairing of mammograms with lung CT screening in a 54-woman study and found that a little more than half of eligible women contacted were willing to undergo the combined screening; Stanford Medicine has said it is now beginning to build that approach into its own clinics.
A separate Sutter Health patient story describes Ismail using robotic-assisted bronchoscopy to investigate a suspicious lung nodule in Morrice after her cancer recurred. A separate NBC Bay Area report described Ismail launching the broader GLAMS initiative to integrate lung cancer risk assessment into routine mammography visits, asking patients about lung cancer risks and potentially recommending further testing.
