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| An epidemic of lung cancer among American women has been quietly growing for decades, and an end to the upsurge appears nowhere in sight, doctors report today.
For women, deaths due to lung cancer now outstrip those caused by breast cancer and all gynecologic cancers combined, the researchers report today in the Journal of the American Medical Association. The team of medical scientists who assessed the scope of lung cancer in women say mortality has continued to climb in women even as smoking and deaths from the disease have declined in men.
Deaths caused by lung cancer rose 600 percent in U.S. women between 1930 to 1997, and continue to rise, the team of scientists said. Drawn to cigarettes largely as a method of weight control, young women are as attracted to the habit as their counterparts were in the era of Franklin Delano Roosevelt. Although doctors have linked some lung cancers to industrial exposures and a small percentage to secondhand smoke, more than 80 percent of cases are associated with a smoking habit. A minuscule number of the cancers occur annually in people who have no known risk factor.
“This is a true epidemic,” said Dr. Jyoti Patel, an instructor in hematology and oncology at Northwestern University’s Feinberg School of Medicine in Chicago. “The numbers are far beyond what we would have imagined 30 years ago. In fact, the numbers are in excess of what we would have predicted, and they continue to increase.”
The American Cancer Society estimates 68,510 women will die of lung cancer this year compared with 40,110 who will die of breast cancer. Another 16,090 will die of ovarian cancer, 7,090 of uterine cancer and 3,900 of cervical cancer.
“People need to realize that lung cancer is a women’s disease,” added Patel, lead author of the study.
“When you talk to most women, they don’t seem to realize that they have a real susceptibility to lung cancer.”
Dr. Mark Kris, chief of thoracic oncology at Memorial Sloan-Kettering Cancer Center in Manhattan, said not only have smoking-incidence and lung-cancer deaths risen in women, they have continued to do so because the social pressures that drive smoking have not changed.
“The core message of the paper is the number of young women who start smoking and how that number has grown astronomically, especially in the last decade or so.
“The face of lung cancer has changed,” Kris added. “It used to occur mostly among people who were current smokers. The average person now getting cancer stopped smoking decades ago.” Risks for the disease never declines to zero, Kris said. Genetic damage remains in the lungs decades after smoking ceases.
Kris and his colleagues also found a biologic disparity between the genders when comparing smokers and their cancers. Women smokers are more likely to have estrogen receptors stippling tumor cells, driving the growth of lung cancer.
Citing earlier work, Kris said, studies have suggested that women generally smoke fewer cigarettes per day than do men, but fewer cigarettes do not equate with a lower cancer risk.
Despite the devastating mortality rate, women fare better than men when treated for the disease, especially with the new so-called targeted therapies that hone in on vulnerable sites on tumor cells. Doctors have been unable to explain the difference, but suspect a complex interplay among genes, hormones and the drug may supply part of the answer.
Dr. Peter Bach, an epidemiologist at Memorial Sloan-Kettering, said lung cancer alone now accounts for 25 percent of all cancer deaths in women.
“We're trying to send a very strong public health message,” Bach said of the study. “This is a very disastrous thing going on here with young women who are taking up smoking. Lung cancer is just one smoking-related illness. We're hoping this will help people think about smoking and get them to quit.” |
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