Lung cancer now leading cause of cancer death in women

April 13, 2004

Tobacco use in American women rose dramatically during the 20th century, resulting in a 600 percent increase by the year 2003 in the number of women who died of lung cancer. In the same period, the number of lung cancer deaths in men declined.

Lung cancer has now surpassed breast cancer as the leading cause of cancer death, accounting for one fourth of all female cancer deaths last year. In 2004, lung cancer will cause as many deaths in women as breast and all gynecologic cancers combined.

Several studies have reported that women are more susceptible than men to the lung cancer-causing effects of cigarette smoking, although this issue remains somewhat controversial.

What is not controversial, according to Northwestern University researcher Jyoti D. Patel, M.D., is that lung cancer appears to be a different disease in women.

In an article in the April 14 issue of The Journal of the American Medical Association, Patel and colleagues from Memorial Sloan-Kettering Cancer Center, New York, discuss differences in the biology of lung cancer between the sexes, including genetic mutations, increased production of certain enzymes that help trigger cancer growth and hormonal changes.

"Genetic, metabolic and hormonal factors all are important to the way women react to carcinogens and lung cancer. This information should impact how we evaluate and screen patients who smoke and how we direct smoking cessation and lung cancer prevention programs," Patel said.

For example, women are more likely than men to develop adenocarcinoma, a subtype of lung cancer, than are men. Adenocarcinoma, once a rare type of lung cancer, is now the most common type of lung cancer and is less associated with smoking than other types of lung cancer. Adenocarcinoma is the most common form of lung cancer present in young persons, those who never smoked and women of all ages.

Patel said that this difference in prevalence between sexes suggests basic differences in lung cancer.

"Mounting evidence suggests that these differences could be due, in part, to estrogen," Patel said.

Research has found that lung cancer cells have more estrogen receptors on their surface than normal lung cells. Other studies have shown an association between estrogen replacement therapy and development of adenocarcinoma of the lung and a positive interaction between estrogen replacement, smoking and development of adenocarcinoma of the lung, Patel said.

Patel also noted that once women have lung cancer, they experience a survival benefit that is not accounted for solely by a longer life expectancy or imbalance of other prognostic factors.

Most major studies for lung cancer prevention in the past have excluded women. The researchers believe it is critical that future lung cancer research specifically include a portion of women that reflects the true incidence of lung cancer in females.

"Given these differences, it is critical that future lung cancer research specifically include a proportion of women that reflects the true incidence of lung cancer in females," they said.

Perhaps the biggest challenge lies in avoiding a similar sad story in other parts of the world, the researchers said. Sociocultural constraints that previously discouraged tobacco use by women continue to weaken in many developing countries. Around 20 million women have started smoking in China in the past 10 years, and after aggressive promotional campaigns in Japan that targeted women and girls, smoking among women there has doubled in just five years.

Patel and co-authors caution that the extraordinary increase in lung cancer rates seen in American women in the 20th century will be repeated in women of developing countries during this century unless effective tobacco control measures are implemented.
-end-
To reach Drs. Bach and Kris, call 212-639-3573.

Patel is instructor in medicine in the division of hematology/oncology at the Feinberg School of Medicine, a researcher at The Robert H. Lurie Comprehensive Cancer Center of Northwestern University and an attending physician at Northwestern Memorial Hospital.

Her co-researchers on the study were Peter B. Bach, M.D., assistant attending physician in the department of epidemiology and biostatistics, and Mark G. Kris, M.D., chief, thoracic oncology service, Memorial Sloan-Kettering Cancer Center. Kris was senior author on this article.

Northwestern University

Related Lung Cancer Articles from Brightsurf:

State-level lung cancer screening rates not aligned with lung cancer burden in the US
A new study reports that state-level lung cancer screening rates were not aligned with lung cancer burden.

The lung microbiome may affect lung cancer pathogenesis and prognosis
Enrichment of the lungs with oral commensal microbes was associated with advanced stage disease, worse prognosis, and tumor progression in patients with lung cancer, according to results from a study published in Cancer Discovery, a journal of the American Association for Cancer Research.

New analysis finds lung cancer screening reduces rates of lung cancer-specific death
Low-dose CT screening methods may prevent one death per 250 at-risk adults screened, according to a meta-analysis of eight randomized controlled clinical trials of lung cancer screening.

'Social smokers' face disproportionate risk of death from lung disease and lung cancer
'Social smokers' are more than twice as likely to die of lung disease and more than eight times as likely to die of lung cancer than non-smokers, according to research presented at the European Respiratory Society International Congress.

Lung cancer therapy may improve outcomes of metastatic brain cancer
A medication commonly used to treat non-small cell lung cancer that has spread, or metastasized, may have benefits for patients with metastatic brain cancers, suggests a new review and analysis led by researchers at St.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Lung transplant patients face elevated lung cancer risk
In an American Journal of Transplantation study, lung cancer risk was increased after lung transplantation, especially in the native (non-transplanted) lung of single lung transplant recipients.

Proposed cancer treatment may boost lung cancer stem cells, study warns
Epigenetic therapies -- targeting enzymes that alter what genes are turned on or off in a cell -- are of growing interest in the cancer field as a way of making a cancer less aggressive or less malignant.

Are you at risk for lung cancer?
This question isn't only for people who've smoked a lot.

Read More: Lung Cancer News and Lung Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.