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Lung Cancer Declining for Men but Not Women
Women show much higher survival rates
March 8, 2005 – While lung cancer is declining in
men, it is holding steady for women and significantly narrowing the
gender gap. Lung cancer leads all other cancers in killing women and is
second only to breast cancer in being found in women. This new study
found lung cancer rates much higher among women under age 50. The good
news for women, however, is that survival rates are much higher than
they are for men. The median age for lung cancer diagnosis was 66.
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Nov. 22, 2004 – Prostate cancer is the most frequent
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11/18/04*
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"Traditionally, lung cancer has been viewed as a
disease of older male smokers, but that is not necessarily the case,"
said the study's author, Gregory P. Kalemkerian, MD, University of
Michigan Medical Center, Ann Arbor, MI. "This data supports the fact
that lung cancer is becoming a bigger problem in women every year. If
these current trends continue, in 10 to 15 years, the incidence of lung
cancer will be identical for women and men."
Results of the most comprehensive analysis to date
of the impact of gender differences in lung cancer incidence in the
United States indicate that lung cancer rates among men are on the
decline, while the rate in women remains steady. The new study in the
March issue of CHEST, the peer-reviewed journal of the American College
of Chest Physicians, shows that, in addition to the unequal incidence of
lung cancer in men and women, there are other gender-linked differences,
including subtype of lung cancer and survival rate.
Researchers found that the incidence of lung cancer
in men reached a peak in 1984, when 72.5 of every 100,000 men had the
disease, then declined to 47 per 100,000 men in 1991.
In sharp contrast, the incidence of lung cancer in
women continued to rise to a peak with 33.1 per 100,000 women in 1991,
and then remained relatively stable at 30.2 to 32.3 per 100,000 women
from 1992 to 1999.
These variations have resulted in a male/female
incidence ratio change from 3.56:1 in 1975 to 1.5:1 in 1999.
For both men and women, the median age of diagnosis
was 66 years.
Women made up 40.9% of patients under the age of 50
but only 35.4% of patients over the age of 50.
"The fact that women appear to be overrepresented
among women under the age of 50 is a reflection of increased smoking
prevalence among women, especially early in the study period," said Dr.
Kalemkerian.
"There is still controversy as to whether or not
women are more susceptible to tobacco carcinogens, but our findings
suggest that women and men are affected differently by their tobacco
use. For example, nearly half the women (44.7%) developed adenocarcioma,
while the men were most likely to develop squamous cell carcinoma
(36.3%)," he said.
The study also found that women had significantly
higher rates of survival at every stage of the disease.
From 1975 to 1987, the five-year survival rate was
12.1% greater in women than in men, and, from 1988 to 1999, women's
five-year survival rate was 6.5% higher.
Even when researchers compared the survival of
early-stage patients who all underwent surgery, they found that after
two years, 74.3% of women survived, compared to 66.0% of men, and, after
five years, 56.8% of women survived, compared to only 48.3% of men.
Researchers speculate that the difference in
survival can be attributed to men having more frequent comorbid
conditions, such as heart disease or severe emphysema. Aside from the
stage of disease, being a man was the factor that most negatively
impacted survival among patients.
"Lung cancer is the leading cause of cancer-related
mortality for women in the United States," said Paul A. Kvale, MD, FCCP,
President of the American College of Chest Physicians. "Although it used
to be considered a male smoker disease, this shortening gender gap
clearly illustrates a behavior shift over recent years in women. This
study reinforces the need for physicians to focus on women who are
susceptible to lung cancer."
Researchers from the University of Michigan Medical
Center and Wayne State University analyzed data of 228,572 patients
(81,843 women and 146,729 men) with lung cancer who were registered in
the national, population-based Surveillance, Epidemiology, and End
Results (SEER) database between 1974 and 1999.
CHEST is a peer-reviewed journal published by the
ACCP. It is available online each month at www.chestjournal.org. ACCP
represents 16,000 members who provide clinical respiratory, sleep,
critical care, and cardiothoracic patient care in the United States and
throughout the world. The ACCP's mission is to promote the prevention
and treatment of diseases of the chest through leadership, education,
research, and communication. For more information about the ACCP, please
visit the ACCP Web site at
http://www.chestnet.org.
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