Female Smokers Face Double the Risk for Lung Cancer Compared to Male Smokers, Study Finds
Women are twice as likely to develop lung cancer as men, found a new study of nearly 17,000 U.S. smokers.
Paradoxically, the new findings also suggest that women are more likely than men to survive the disease, should it arise.
of the international, multicenter study – led by Dr. Claudia
Henschke of NewYork-Presbyterian Hospital/Weill Cornell Medical Center
in New York City – could have important lessons for public health
efforts aimed at reducing deaths due to smoking.
findings highlight the need to educate younger women that they are at
higher risk of developing lung cancer, even when they're smoking the
same amount as men," said Dr. Henschke, principal investigator of
I-ELCAP and chief of Chest Imaging in the Department of Radiology at
NewYork-Presbyterian/Weill Cornell, and professor of radiology at Weill
Cornell Medical College. "Based on their excess vulnerability to
tobacco smoke, women may also need to get screened for lung cancer
earlier than men," she said.
remains the single largest cancer killer of both sexes in the United
States, with more than 90,000 men and 73,000 women falling victim to
the disease each year. In fact, lung cancer kills more U.S. women
annually than the next two leading malignancies (breast and colon
And yet, until now, gender differences in lung cancer have been poorly understood.
followed up on preliminary research involving 2,490 smokers taking part
in the Early Lung Cancer Action Project (ELCAP).
"That first series only included people enrolled in our institution in New York City," Dr. Henschke explaied.
The new data
includes a total of 7,498 female and 9,427 male smokers who underwent
CT lung cancer screening at centers across North America. "The results
are now more generalizable to the country as a whole," Dr. Henschke
All of the
study participants were current or former smokers aged 40 or older who
showed no symptoms of lung cancer at the time of screening. Lung cancer
was diagnosed in 156 of the 7,498 female participants (2 percent) and
113 of the 9,427 men in the study (1.2 percent). After adjusting for
differences of age and smoking history, women were found to have almost
twice the risk of lung cancer (odds ratio of 1.9).
that female smokers were nearly twice as likely to develop lung cancer
compared to men of the same age and smoking history," Dr. Henschke
But there was another intriguing finding: Women who developed lung cancer were also 52 percent less likely to die from the disease than men (hazard ratio of 0.48), the researchers found.
statistic held even after adjusting for factors such as smoking
history, disease stage at diagnosis, tumor type and interventions such
up some of the long-standing confusion surrounding gender and lung
cancer," Dr. Henschke said. "Yes, given the same exposure, women are
less likely to die from lung cancer than men, but they also have double
the risk of getting the disease."
really sure why that might be," Dr. Henschke added. "Is the women's
cancer just less aggressive? Or is it more curable? We just don't know,
but it's certainly an area that deserves more research," she says.
In the meantime, preventive efforts aimed at young women may be key to lowering lung cancer incidence, she said.
"We have to
get the word out to teen girls, especially, that their long-term risk
of developing cancer is higher than that of males with similar smoking
histories," she says. "The best way to avoid lung cancer is to never
take up smoking in the first place."
heightened susceptibility to lung cancer also supports the need for
earlier screening for female smokers, Dr. Henschke said.
"Based on our
evidence, we believe that the screening threshold for women of a given
age should be some 50 pack-years lower than that of men of the same
age," she says.
Screening can and does save lives, Dr. Henschke said.
"Whatever your gender, early detection remains our very best weapon for beating this terrible disease," she observed.
The study was published in the Journal of the American Medical Association (JAMA)
authors include Dr. Nasser Altorki, Dr. Ali Farooqi, Dr. Daniel Libby,
Dr. Dorothy I. McCauley, Dr. Mark Pasmantier, Dr. Anthony P. Reeves,
Dr. James P. Smith, Dr. Madeline Vazquez, Dr. David F. Yankelevitz,
Rowena Yip, Kimberly Agnello, Arin Kramer and Jennifer Hess -- all of
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