Lung cancer rates fell for Marlboro man, but rose sharply for non-smokers and young women – oncologist explains why

Environ 20 % des femmes atteintes d'un cancer du poumon n'ont jamais fumé.  <a href=Mallika Wiriyathitipirn/EyeEm via Getty Images” src=”–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTQ3MA–/” datac “–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTQ3MA–/”

When many people think of the average lung cancer patient, they often imagine an older man who smokes. But the face of lung cancer has changed. Over the past 15 years, more and more women, people who have never smoked and young people have been diagnosed with lung cancer.

In fact, lung cancer is the leading cause of cancer death in women, and more women die each year from lung cancer than from breast, ovarian, and colorectal cancer. The American Lung Association reports that while lung cancer rates have increased by 79% in women over the past 44 years, they have decreased by 43% in men. And for the first time in history, more young women than men are diagnosed with lung cancer.

As a thoracic oncologist at Sylvester Comprehensive Cancer Center, part of the University of Miami Health System, I have seen many younger, never-smoking women come into my clinic with a new diagnosis of lung cancer. . Particularly for non-smokers, lung cancer is unexpected for both patients and their doctors, which can often lead to diagnostic delays. Researchers have described this trend of rising lung cancer rates among women in different parts of the world and are beginning to understand why cases are on the rise.

Lung cancer in women

The primary explanation for rising lung cancer rates among women is that many started smoking later than men, which pushed back their peak in smoking-related lung cancer diagnoses.

Women also started smoking in the years when filter cigarettes were most commonly used. This has led to an increased risk of a type of cancer called adenocarcinoma due to the way cigarette filters distribute tobacco smoke to the outer parts of the lungs. Some studies suggest that women are more susceptible to the carcinogenic effects of exposure to tobacco and cigarette smoke, including second-hand smoke, and may develop lung cancer after fewer years of smoking than men.

However, it is important to note that most people diagnosed with lung cancer today are not active smokers. About 20% of women with lung cancer have never smoked, which is higher than among men with lung cancer who have never smoked.

Lung cancer risk factors

Besides smoking and second-hand smoke, there are several other risk factors for lung cancer. These include a family history of cancer and exposure to asbestos, radon and air pollution.

Exposure to workplace carcinogens in the form of inhaled chemicals such as arsenic, beryllium, cadmium, silica and nickel remains a concern in some parts of the world. The potential risk of lung cancer associated with e-cigarette and marijuana smoke is still under investigation, but is of potential concern.

Recently, researchers have also found that genetics may play a role in lung cancer risk in some patients with a strong history of lung cancer. Studies of these families have identified potential lung cancer susceptibility genes and environmental risk factors.

Like BRCA1 and BRCA2 in breast cancer, alterations in genes that promote or protect against tumor development may contribute to the development of lung cancer. Researchers have yet to identify the specific mutations that may predispose individuals to lung cancer. However, the study of familial genetic predispositions can help elucidate the development of lung cancer and lead to new biomarkers for the early detection of cancer in high-risk groups.

Lung cancer screening

In 2021, the United States Preventive Services Task Force updated its lung cancer screening guidelines to include younger patients with less smoking history. Now, lung cancer screening is recommended for adults ages 50 to 80 who have smoked at least one pack a day for 20 years, current smokers, and former smokers who have quit within the last 15 years. Women at risk for lung cancer can talk to their doctor about ordering a low-dose CT scan for lung cancer screening.

Nationally, more than 70% of eligible women are screened for breast cancer, but less than 6% of all eligible smokers are screened for lung cancer. The researchers estimate that these new screening guidelines will increase the number of women eligible for lung cancer screening by 40%, including those who are younger and less exposed to smoking.

Une tomodensitométrie à faible dose peut aider à la détection précoce du cancer du poumon.  Dans cette image, la tumeur est le nodule blanc dans le coin supérieur droit de l'espace noir.  <a href=Atlas of Lung Pathology/Flickr, CC BY-SA” data-src=”–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTU2Mg–/″3d180370″ />

Diagnosis of lung cancer

In recent years, a better understanding of the genetic changes that can lead to cancer and how to harness the immune system to treat cancer has led to new targeted therapies and immunotherapies that have improved the prognosis of patients with breast cancer. lung. Women tend to have a better prognosis for lung cancer than men, especially if they have never smoked and have tumors with molecular changes that can be treated with targeted therapies.

However, symptoms of lung cancer may go unnoticed in women. Symptoms of lung cancer can include coughing, shortness of breath, overwhelming fatigue, and pain in the back, chest, or shoulder, which could be mistaken for other conditions. Since women tend to be slightly younger at diagnosis than men, patients may be able to tolerate symptoms longer and delay seeking medical attention. Doctors also might not attribute these symptoms to lung cancer due to the young age of the patient.

Recognizing early symptoms of lung cancer, expanding eligibility for lung cancer screening, and testing genetic biomarkers to select the best treatment are some of the steps that could help tackle the global lung cancer epidemic in the women.

This article is republished from The Conversation, an independent, nonprofit news site dedicated to sharing ideas from academic experts. The Conversation is trusted information from experts, from an independent, non-profit organization. Try our free newsletters.

It was written by: Estelamari Rodriguez, University of Miami.

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Estelamari Rodriguez is affiliated with the University of Miami Health System. She receives funding from the American Cancer Society.

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