Lung Cancer Risk Assessment and Etiology

Inclusion Criteria: * Have had clinical germline genetic testing and/or have consented or expressed a willingness to consent to the City of Hope (COH) General Research Protocol COH IRB # 07047 * Age \>= 18 years * Willing to have about 30 mL of blood (approximately 2 tablespoons) drawn during the aspiration visit * Speak English, Spanish, or Mandarin * Lung cancer patients: meeting at least one of the following criteria: * Be a never-smoker with lung cancer (excludes atypical/typical carcinoid and small cell tumors) * Be diagnosed with lung cancer =\< 50 years of age * Have a germline alteration known/suspected to be associated with elevated lung cancer risk * Have a strong family history of lung cancer (\>= one first, second or third degree relative with never-smoking lung cancer, \>= three first, second or third degree relative with lung cancer in one lineage \[side of the family\], \>= one first, second or third degree relative diagnosed with lung cancer under the age of 50. Patients may also be considered eligible if they meet the family history criteria in part and have a truncated family structure \[e.g., only one first and one second degree relative with lung cancer in a small family\]) * Unaffected patients (i.e., those without a lung cancer diagnosis and other cancer diagnosis for the past 5 years) who are at least 50 years of age or at most age 10 years younger than the first case of lung cancer in the family, meeting at least one of the following criteria: * Have a germline alteration known/suspected to be associated with elevated lung cancer risk * Have a strong family history of lung cancer (\>= one first, second or third degree relative with never-smoking lung cancer, \>= three first, second or third degree relative with lung cancer in one lineage \[side of the family\], \>= one first, second or third degree relative diagnosed with lung cancer under the age of 50. Patients may also be considered eligible if they meet the family history criteria in part and have a truncated family structure \[e.g., only one first and one second degree relative with lung cancer in a small family\]) * Of East Asian descent with any family history of lung cancer * Documented informed consent of the participant Exclusion Criteria: * Unable to provide informed consent * Patients who fall under the unaffected cohort criteria but received chest imaging (except chest x-ray) within the last year