Women and lung cancer
- Elizabeth H Baldini, MD, MPH
Elizabeth H Baldini, MD, MPH
- Associate Professor of Radiation Oncology
- Harvard Medical School
- Section Editors
- Peter J Barnes, DM, DSc, FRCP, FRS
Peter J Barnes, DM, DSc, FRCP, FRS
- Editor-in-Chief — Pulmonary and Critical Care Medicine
- Section Editor — Asthma
- Professor of Medicine
- National Heart and Lung Institute, Imperial College, London
- James R Jett, MD
James R Jett, MD
- Section Editor — Lung Cancer
- Professor of Medicine Emeritus
- National Jewish Health
- Rogerio C Lilenbaum, MD, FACP
Rogerio C Lilenbaum, MD, FACP
- Section Editor — Lung Cancer
- Yale Cancer Center
The epidemic of lung cancer in women is reviewed here, focusing on epidemiologic issues, risk factors, outcome, and prevention. General issues related to lung cancer risk and its clinical presentation are discussed separately. (See "Cigarette smoking and other possible risk factors for lung cancer" and "Overview of the risk factors, pathology, and clinical manifestations of lung cancer".)
Worldwide, lung cancer is the third most common cancer in women, behind breast and colorectal cancers, accounting for 580,000 cases and 490,000 deaths in 2012 . In the United States, lung cancer is now the leading cancer killer of women, having surpassed breast cancer in 1987 (table 1). Almost twice as many women in the United States are expected to die from lung cancer compared with breast cancer in 2017 (approximately 71,300 versus 40,600) .
The age-adjusted lung cancer death rate has risen in parallel to the smoking rate among women, with the increase in lung cancer deaths following the increase in smoking incidence by approximately 20 years. This separation reflects the latency period between smoking and death from lung cancer. Specifically, the smoking rate for women rose dramatically in the United States from 1930 to 1960, and this was followed by a rapidly increasing lung cancer death rate that began in 1960 (figure 1) [3-7]. The lung cancer death rate in women has reached a plateau and has now started to decline with a reported decrease of 1.1 percent per year from 2003 to 2009 . The same trend has been documented in many European countries .
Comparison of men and women — Lung cancer mortality has been and continues to be more common in men than women . However, the magnitude of this difference continues to decline due to increases in the female lung cancer mortality rate while the mortality rate in males has decreased [9,10].
The age-adjusted lung cancer incidence continues to be higher in men than women. However, the magnitude of this difference has decreased, which reflects the fact that the female incidence rate is stabilizing while the male incidence rate continues to decrease [5,10,11].
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