Lung cancer is the leading cause of cancer deaths worldwide. Historically, there has been a higher lung cancer burden among men than among women - partially attributed to their higher prevalence of smoking behaviors in addition to their participation in more risky careers (mining, construction, etc.). However, in recent years, there has been a dramatic increase in the prevalence of lung cancer among women, despite no statistically significant changes in what percentage of women who smoke or are exposed to substances like asbestos and radon.
Lung Cancer Risk Factors
A recent study found that lung cancer rates are higher in women aged 30-49 in six developed countries - Canada, Denmark, Germany, New Zealand, the Netherlands, and the United States. These increases appear to be due to a large increase in cases of adenocarcinoma - the most common type of cancer found in people who don't smoke. While this type of cancer makes up about 40% of lung cancer cases, it is much slower-growing than other tumors and can take longer to find and diagnose - meaning an increased risk of metastasis. While smoking can be a contributing risk to developing adenocarcinomas, it is the lowest contributor here. Other contributing risk factors include air pollution, heavy metals, diesel exhaust fumes, and beta-carotene supplement usage.
But why do women have an increased risk?
More women began smoking once cigarettes became filtered - in fact, there are several brands of filtered cigarettes that are tailored and marketed for women, like Virginia Slims, Capri, and Misty. Because of how filters on cigarettes distribute the tobacco smoke to the outer parts of the lungs, they increase the overall risk of developing adenocarcinomas. Furthermore, the most dramatic decline in smoking behavior is seen in men, meaning the resulting decrease in lung cancer risk is also observed in men - naturally, the risk for women is proportionately higher in women than previously seen.
How smoking REALLY affects lung cancer risk
One of the contributing factors to the risk of lung cancer for anyone is the length of time smoked; in fact, this has more impact on one's risk of developing lung cancer than if they quit or how long ago they quit. Studies have shown that 24% of lung cancer cases in women occur in those who never smoked at all.
The other contributing factors...
It has been postulated - but not yet proven - that because women's immune systems are meant to tolerate the presence and growth of a baby, an immunologically distinct foreign growth for all intents and purposes here, they are more susceptible to pollutants and other immunologically distinct materials that are inhaled from their natural environment and lead to the growth of early cancers. Thus, secondhand smoke, radon gas, and other air pollutants may have a greater effect on the lung cancer risk for women than they do for men.
Age is more than just a number!
Furthermore, the increased risk of lung cancer in women appears to begin with the age groups in their late 30s and 40s - a time when women may also experience declines in natural estrogen production, the beginnings of menopause, PCOS diagnosis, and hormonal birth control use. Studies have shown that hormone replacement therapies and estrogen use can increase tumor growth and contribute to other pre-existing genetic factors to cause the growth of adenocarcinomas.
Traditional gender roles: continuing to screw women over in 2023.
While it is now the 21st century, and far more families are splitting duties at home as both spouses work outside the home, many women still remain the sole chef for the household. Research shows that 80% of women are still the sole person responsible for food shopping and cooking for their families.
This is important to lung cancer research, as certain cooking methods increase the risk of developing cancer. For instance, women who cook with coal are more likely to develop lung cancer than those who do not. Additionally, cooking oils lead to the formation of carcinogens, which women who use cooking oils may be more susceptible to if they are not cooking in a well-enough ventilated area.
Lung cancer: another women's issue that is not receiving enough research or funding.
Clearly, more research is needed into the change in lung cancer risk and what this means for men and women. Research into illnesses that plague women is, and has long been, sorely lacking for centuries. Unfortunately, it appears that lung cancer will be no different, as the public health focus continues to be on anti-smoking and smoking cessation campaigns and education.
While this is important, it is time for epidemiologists to investigate the reasons behind the increased risk for women and produce supportable data, so that public health officials can then create educational programs and campaigns directed at the women who are at an increased risk to be affected. Perhaps in the coming decade, the world may see a decrease in the lung cancer burden and mortality rates among women as well as men.
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