The Voice
Women And Lung Cancer: A Special Focus On Asian Women
How common is lung cancer in women?
Lung cancer kills more women than any other cancer. “This ‘hidden’ women’s cancer is the least federally funded cancer, in terms of research dollars per death of all the major cancers. It is one of the only cancers where patients are routinely blamed as responsible for their condition.”
According to The American Lung Association, although the overall number of lung cancer cases has across men and women has been relatively steady, the number of women who have been diagnosed with lung cancer has increased by 84%, over the last 42 years. In contrast, the number of men diagnosed with lung cancer has dropped by 36%.
Every day 171 women die of lung cancer, and it is the leading cause of cancer death among women. According to a 2021 study published in Contemporary Oncology, lung cancer is the second most common cancer in both men and women, just behind breast cancer for women. Unfortunately, lung cancer receives the least federal funding. Although breast cancer is much more common, it is also much more survivable. The Lung Cancer Research Foundation says that lung cancer kills 1.5 times as many women as breast cancer.
The likelihood of developing lung cancer is particularly high among Asian women, even those who have never smoked. This population is twice as likely to develop lung cancer as than other women who do not smoke. An interview about lung cancer studies on the female Asian population in the Bay Area cited 18 publications and four funded studies that showed that more than 50% of Asian American women who developed lung cancer did not smoke. Complicating matters is the fact that traditional research studies tend to lump Asian women together, when really, they include women from 20 different countries. If you disaggregate the data and look at ethnic groups, the statistics can be even more alarming — the rate of lung cancer is as high as 80% among Chinese women, for example. Detecting the disease in Asian women who do not smoke or seldom smoke is also difficult because they are also not eligible for lung cancer screenings.
How does lung cancer differ in women and men?
Lung adenocarcinoma is the most common type of lung cancer for both men and women, according to the Lung Cancer Research Foundation. But there are also unique ways in which the disease impacts women. According to a 2021 study published in Frontiers in Medicine, women are more likely to be diagnosed earlier, and to be diagnosed even if they are not smokers. Up to 50% of women with adenocarcinoma do not smoke.
The higher diagnosis rate, despite lower smoking rates, indicates that the carcinogens in tobacco may impact women more than men. The Frontiers in Medicine study also found that 64% of the deaths due to secondhand smoke were in women. The same study also found that air pollution is also likely to cause lung cancer.
The same study continues and states that many medical professionals consider lung adenocarcinoma to be a different disease in women than in men. The presence and absence of estrogen can impact how lung cancer plays out, which not only makes the disease different for men vs. women, it also means that women who have not yet reached menopause respond much differently to adenocarcinoma than women after menopause do.
According to the Frontiers in Medicine study, women who were diagnosed with lung cancer before menopause were usually diagnosed in more advanced stages, had more aggressive tumors and did not survive as often as men and women who were diagnosed after menopause.
What can medical professionals do to treat women with lung cancer?
The good news is that more than one clinical trial has suggested that lung cancer screenings are more helpful for women, according to a 2022 study published in The Annals of Thoracic Surgery. And about 14.5 million Americans qualify for CT scan screenings, according to a 2021 blog post by Penn Medicine.
According to the blog post, people who may qualify for screenings include:
• Former smokers
• Smokers
• Adults with exposure to radon gas
• Adults with exposure to asbestos
• People with exposure to air pollution
• People who are exposed to secondhand smoke.
Researchers in the Frontiers study had several suggestions for women-focused cancer research going forward. They suggested that researchers focus on factors other than smoking that can cause lung cancer, since the number of female nonsmokers who are diagnosed with the disease is high. They also suggest that because women are impacted differently than men, studies should have as many women as possible, and include women who are both before and after menopause. Their third recommendation was to suggest that doctors study the impact of estrogen on lung cancer in more detail.
Sources
GO2-Foundation_women-and-lung-cancer_2022.pdf | GO2 Foundation
Lung Cancer Fact Sheet | American Lung Association
Epidemiology of lung cancer (termedia.pl)
An Overview of Lung Cancer in Women and the Impact of Estrogen in Lung Carcinogenesis and Lung Cancer Treatment | Frontiers
Lung Cancer in Women | ScienceDirect
What Women Need to Know About Lung Cancer | Penn Medicine
Addressing High Lung Cancer Rates Among Female Asian Non-Smokers | UCSF Helen Diller Family Comprehensive Cancer