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January 2024 | George M. Pikler, M.D., Ph.D., FACP

Younger Women Getting Lung Cancer at Higher Rates Than Men

Lung cancer remains the leading cause of cancer death among both men and women in the United States. The Centers for Disease Control and Prevention (CDC) estimates that, nationwide, around 197,000 people are diagnosed with the disease each year. Of those, about 136,00 die from the disease. According to the American Lung Association, lung cancer is the number one killer of women.

Researchers at the American Cancer Society reported recently that women between the ages of 35 and 54 are being diagnosed with lung cancer at higher rates than men in that same age group. Part of the reason is the decline in the number of men getting lung cancer, which has been larger than the decline in women. The disparity is small — one or two more cases among every 100,000 women in that age range than among men — but it is significant enough that researchers want to know more.

About 15 to 20 percent of lung cancer cases in women are among those who have never smoked. Several risk factors have been considered: family history, secondhand smoke, air pollution, asbestos, residential radon exposure, and arsenic in drinking water. Or women might metabolize carcinogens differently from the way men do.

The interaction between tobacco carcinogens and endogenous and exogenous sex steroids may be important. Women taking hormone replacement therapy (HRT) or oral contraceptives experienced to have an increased lung cancer incidence. Epidemiologic data on HRT show a significant association between both a younger median age at lung cancer diagnosis and a shorter median survival time. Another clue is the significantly higher number of lung cancer diagnosed women who are largely premenopausal in comparison to diagnosed men in the same age or women with shorter menstrual cycles.

Ultimately there is no clear-cut explanation for the disparities. There is a push to get more funding to study these differences in hopes of identifying them so public health leaders could target those particular issues. Experts urge women to get screened if they qualify. If they have a close family history of lung cancer not associated with smoking, they should talk to their doctor about evaluating their cancer risk. And everyone should be aware of symptoms of lung cancer. Early signs can include a cough that lasts for longer than six weeks, upper back pain, shortness of breath and unexplained weight loss. Some people may also develop hoarseness and in severe cases, hemoptysis.

JAMA Oncol. 2023; 9 (12);1727-1728
JAMA Oncol. 2021; 7 (2); 302-304
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Erica

Erica Cross, PA

PA

Erica is a board certified Physician Assistant. She obtained her Master’s degree in Physician Assistant studies from Our Lady of the Lake College in Baton Rouge, LA. She began practicing in 2011 and has worked clinically in Orthopedics and Dermatology. The majority of her career has been spent in a Dermatology practice where she assisted in Mohs surgery, treating various types of skin cancer. She also teaches in the medical simulation department at the University of South Alabama and enjoys every aspect of medical education.