Among Non-Smokers, Women Are Twice as Likely To Get Lung Cancer Than Men
Lung cancer, and its impact on women has received little attention until recently. It has long been known that there are several actors in Hollywood who have been diagnosed, but many are not willing to make their illness public for fear of the stigma. In the January 15th, 2024, issue of People magazine, actress Susan Sullivan, the mother in the TV series, “Castle,” describes her experience with lung cancer diagnosis and treatment. Her candor and courage to discuss her personal journey is inspiring.
Historically, lung cancer was considered a man’s disease because cigarettes were first marketed to men, and many men were exposed to carcinogens in the workplace. However, the October 2023 study in the Journal of The American Medical Association (JAMA) Oncology edition compared how much lung cancer impacts men and found that in the last 50 years lung cancer in women between the ages of 35 and 54 is more common than it is among men in the same age group. While cancer rates for both women and men are decreasing, (the projected diagnoses were around 117,000 for men and 121,000 cases for women in 2023), lung cancer is still the number one cancer killer, and takes the lives of 1.5 times more women than breast cancer, which continues to shock most people.
Causes of Lung Cancer in Women
What is still unclear from the JAMA study and other medical literature is why lung cancer seems to be impacting women at a slightly higher rate than men. Doctors and medical researchers have several theories that may explain this finding. Although fewer people and fewer women are smoking, smoking damages lung tissues and exposes smokers to carcinogens, and doctors believe that women may metabolize cigarette smoke differently than men do. Women who do not smoke are still susceptible to exposure to carcinogens from their environment and could explain the higher diagnosis rate. Family history and gene mutations can both play a role in developing lung cancer. Mutations in a gene called the EGFR gene can lead to lung cancer, even in people who have never smoked. Women, and particularly Asian women, are more likely to have mutations in the EGFR gene.
In a November 15, 2023, interview of Dr. Helena Yu by Julie Grisham on Memorial Sloan Kettering studies mutations in the EGFR gene at the Memorial Sloan Kettering Cancer Care Center website, she was quoted saying that as the number of smokers decreases, the number of lung cancer cases among nonsmokers will increase. But because many of the women who have never smoked don’t have the same risk factors as smokers, and because only 20% of lung cancer cases are found in non-smokers, women who do not smoke may not be recommended for screenings, or may have their cancer misdiagnosed as asthma, pneumonia or bronchitis, before it is diagnosed as cancer. This means that they lose critical time to treat the disease before it progresses.
Prevalence of Lung Cancer in Women
According to the Lung Cancer Research Foundation (LCRF), 1 in 17 women will develop lung cancer in their lifetimes. The LCRF also states that among nonsmokers, women are twice as likely as men to be diagnosed with lung cancer than men are. Lung Cancer is also responsible for more deaths than breast cancer, ovarian cancer and cervical cancer combined.
What Will Help Women with Lung Cancer?
A bill called the Women and Lung Cancer Research and Preventative Services Act. This bill would require the Department of Health and Human Services to conduct an interagency review of the status of women and lung cancer. The review must
- report on the status of existing research and current knowledge gaps.
- identify new opportunities for collaborative research to determine the causes of lung cancer and advance prevention, screening, diagnosis, and treatment; and
- provide recommendations for a national cancer screening strategy and public education campaign.
The bill was introduced in 2021, and as of early 2024 is still in the legislative process. In the meantime, women can be extra vigilant about their own health, especially if they lose weight suddenly and unexpectedly, have a cough that lasts more than six weeks, or are coughing up blood.
Dr. Yu also has two suggestions for helping women with lung cancer. She sees that stigmatizing lung cancer as a “smoker’s disease” is something that is harmful and needs to change.
“There is a stigma around lung cancer because of its connection to smoking. But anybody with lungs can get lung cancer. I don’t want patients to ever feel guilty or responsible for their cancer diagnosis,” Dr. Yu said in a Memorial Sloan Kettering post.
She also believes that education is key, both for breaking the stigma and for saving lives.
“I hope that by educating people about lung cancer and its causes, we can decrease the stigma while increasing awareness about early detection and new treatment options.”
Falcon Crest’s Susan Sullivan on Lung Cancer Surgery
Lung Cancer in Women and Nonsmokers: What To Know About Symptoms, Diagnosis, and Treatment
Memorial Sloan Kettering
The Burden of Lung Cancer in Women Compared With Men in the US
JAMA Study / October 2023
Higher rates of lung cancer in women are a mystery for researchers
CNN / October 2023