For the last five years, Vicky Ni has been battling lung cancer — a diagnosis that came out of the blue in 2019 after she went to a doctor for pain in her shoulder.

“He was taking X-rays of my neck, and it was only by chance that the bottom corner of the X-ray showed a raised diaphragm,” Ni said. “I was stunned beyond words.”

The 54-year-old lawyer and mother of two is now part of a medical mystery: lung cancer in nonsmoking, Asian American women had been rising for more than a decade before Ni received her diagnosis.

“I assumed that I would get chemo and beat it. It was only later when I met with an oncologist that I learned that I was stage 4 and therefore incurable,” Ni said.

Of the Asian women diagnosed with lung cancer, 57% are nonsmokers, according to a study by leading California medical centers. For all others, only 15% of the women diagnosed had no history of smoking.

Ni says she doesn’t believe she was exposed to any cancer-causing chemicals and didn’t grow up in an area with a lot of air pollution. As a nonsmoker, she wasn’t eligible to be screened for lung cancer.

“Currently, screening guidelines drive what’s covered under insurance,” said epidemiologist Scarlett Gomez.

Gomez and epidemiologist Iona Cheng of the University of California San Francisco were awarded a $12.5 million grant from the National Cancer Institute.

“Some of the factors we’re looking at include certainly exposure to second-hand smoke, high exposure to cooking oil fumes is an established risk factor,” Gomez said, adding that recent cellular studies suggest that a particular genetic mutation may predispose people to being more vulnerable to air pollution.

At New York University’s Perlmutter Cancer Center, Dr. Elaine Shum is randomly screening 1,000 Asian women for free.

“We are definitely going to need a much larger study to really provide the evidence to try to change the guidelines one day, so that other populations can be offered low-dose CT scans by insurance companies,” Shum said.

Potentially changing the guidelines for earlier detection won’t affect the outcome for Ni and her husband David. “Like any cancer, it affects the whole family,” David said.

But it could offer hope to spare other families that same pain in the future.