Gender Disparities and Lung Cancer

Gender Disparities and Lung Cancer 

July 19, 2019  |  Blog Post

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Lung cancer the leading cause of cancer deaths in the United States [1]. The five-year survival rate is 56%, but falls to 5% if it is detected late [1]. Smoking is the most prevalent carcinogen leading to lung cancer, but in 2018, about 20% of lung cancer mortalities occurred in nonsmokers [2]. As the incidence of lung cancer in nonsmokers increases, it has been found that nonsmoking women are three times more likely to have lung cancer than men [2]. The number of cases of lung cancer has decreased due to the public campaigns against smoking. However, the incidence of lung cancer in women has generally remained steady over the last few decades while the incidence of lung cancer in men has been declining [2].

Various factors affecting this gender disparity have been proposed, including environmental, hormonal, and genetic factors [3]. Estrogen, one of the female-dominant sex hormones, increases lung cancer risk and mortality in smokers and nonsmokers [2]. Cultural and societal gender disparities also affect lung cancer in women. In Asia, it has been shown that excessive inhalation of fumes from cooking can also contribute to lung cancer [4]. Secondhand smoke is a factor in lung cancer. Low-income individuals are more likely to experience secondhand smoke, and women tend to have lower incomes than men [4].

Furthermore, public knowledge of this disparity is low. When the American Lung Association surveyed 1,000 women, only 1% acknowledged lung cancer as a primary concern [25,26]. Only 25% had spoken to their doctor about lung cancer risks. Most women were more concerned with breast cancer, despite the high survival rates for breast cancer compared to lung cancer and similar incidence rates between the two (90% vs. 56% survival and 246,660 vs. 224,390 estimated new cases in 2016, respectively) [2].

The survival rate for lung cancer remains low and has only increased by 5% in the last thirty years [2]. Despite the increasing risk of lung cancer to women and lack of improvement in lung cancer treatment, funding for lung cancer research remains low compared to colon, prostate, and breast cancer [2]. Women, especially minority women, are also less likely to participate in clinical trials for lung cancer [2].

Finally, screening guidelines for lung cancer are focused around smokers with a 30 pack-year history. As lung cancer in nonsmokers, and especially nonsmoking women, is becoming a larger issue, there may be a need to revisit these guidelines [4].

In 2016, Brigham Women’s published a lung cancer report stating a number of policy recommendations to address the gender disparity in lung cancer, particularly in nonsmokers. They suggest increasing public and medical awareness of lung cancer in women, improving preventative lung cancer screening in women, and sponsoring more sex- and gender-specific lung cancer research [2].winners. 

Authors

Anne Wei

Healthcare Analyst at CHI

Citations

1. https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/resource-library/lung-cancer-fact-sheet.html

2. https://www.cancer.org/latest-news/why-lung-cancer-strikes-nonsmokers.html

3. https://www.hopkinsmedicine.org/news/articles/why-are-more-nonsmoking-women-getting-lung-cancer

4. https://www.brighamandwomens.org/assets/BWH/lung-center/pdfs/Women-and-Lung-Cancer-Final-April-22-2010-pdf.pdf