Activation of protein kinase B (PKB/Akt) and risk of lung cancer among rural women in India who cook with biomass fuel

► Carcinogenesis in airway cells was examined in biomass and LPG using women. ► Metaplasia and dysplasia of epithelial cells were more prevalent in biomass users. ► Change in airway cytology was associated with oxidative stress and Akt activation. ► Biomass users had greater exposure to respirable PM, B(a)P and benzene. ► Cooking with biomass increases cancer risk in the airways via Akt activation.