Why are More Young Women Being Diagnosed with Lung Cancer Than Young Men?
4 min. read
Baptist Health Miami Cancer Institute
In a reversal of historic trends, researchers at the American Cancer Society (ACS) have found higher lung cancer incidence in women than in men between the ages of 35 and 54.
The findings, published by the American Cancer Society in JAMA Network, also contradict a common perception that lung cancer occurs mostly in middle-aged or older men who have smoked for many years. Overall, the rates of lung cancer have been falling in the U.S. There were about 65 new cases of lung cancer for every 100,000 people in 1992. By 2019, that figure had dropped to about 42.
In a separate report released this month, the American Lung Association put out its 2023 “State of Lung Cancer” update, finding that the rate of lung cancer screening in Florida “is far too low at 2.4 percent, compared to the national average of 4.5 percent.” Overall, lung cancer survival rates have increased over the past five years, but serious disparities remain among Black and Hispanic/Latino communities in Florida and across the nation, the report finds. Nationally, the report found that only 4 percent of women considered high risk for lung cancer were screened.
The new study by the American Cancer Society found that cigarette smoking did not necessarily affect women more than men. However, smoking is, by far, the leading cause of lung cancer. The survival rate for lung cancer that has not spread is now more than 50 percent in the U.S, but lung cancer is often diagnosed in later stages after it has spread.
Researchers analyzed population-based incidence data on lung and bronchus cancers diagnosed from 2000 to 2019 from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. The data covered nearly 50 percent of the U.S. population. The results showed the declines in lung cancer incidence rates between 2000-2004 and 2015-2019 were greater in men than women, leading to higher incidence in women aged 35-54 years.
Among individuals aged 50-54 years, for example, the rate per 100,000 person-years decreased by 44 percent in men, compared to 20 percent in women, the study found.
What precisely is causing the disparity in lung cancer incidence between men and women in this age range is not known at this time. Other recent research data indicates that non-smoking related risk factors for lung cancer are fueling cases among younger adults, explains , chief of medical oncology, chief scientific officer, and deputy director of research at, and Fernandez Family Foundation Endowed Chair in Cancer Research.
“There is a greater incidence of women being diagnosed at an early stage of lung cancer not related to smoking, and most of them are oncogenic driven (via genetic mutation such as EGFR (epidermal growth factor receptor) tumors,” said Dr. Ahluwalia.
EGFR-positive lung cancer represents about 10-15 percent of lung cancer cases in the U.S., and generally appears in adenocarcinoma subtype of non-small cell lung cancer, according to the American Lung Association. Patients with lung cancers with EGFR mutations tend to have minimal to no smoking history.
New research even points to air pollution particles as a potential cause of EGFR mutant lung cancer. “,” explains Dr. Ahluwalia.
Nonetheless, the precise cause of young women outpacing young men in lung cancer rates remains somewhat of a mystery while the topic fuels ongoing research.
“The cause may be multifactorial,” adds Dr. Dylewski. “I doubt very much that women are starting to smoke more frequently than men, but it also may be hormonal, or it may be environmental. We know that there's an increased instance of adenocarcinoma in women between the ages of 50 and 74 that are completely unrelated to smoking and are found in non-smokers. And that may have some influence. But we don't quite understand why we're seeing an increase in incidence in non-smoking women in that age group.”
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