TUESDAY, April 13, 2004 (HealthDayNews) -- Many women worry that they'll get breast cancer, but a new report says lung cancer is actually a bigger threat to their health.
Last year, nearly 70,000 women died from lung cancer in the United States. That's more deaths than from breast cancer and all gynecological cancers combined. The death rate from lung cancer rose 600 percent between 1930 and 1997, according to the report, which appears in the April 14 issue of the Journal of the American Medical Association.
The paper, agreeing with a report issued by the U.S. Surgeon General, says the nation "is clearly in the midst of an epidemic. Lung cancer in U.S. women occurred suddenly and in numbers clearly in excess of normal expectancy."
"Smoking is the largest risk factor for lung cancer," said study co-author Dr. Jyoti Patel, an instructor of medicine in the division of hematology/oncology at the Feinberg School of Medicine at Northwestern University in Chicago.
"During World War II, women went into the workforce and started to smoke like men. Twenty years later, they started to die like men, from lung cancer," says Dr. Jay Brooks, chief of hematology and oncology at the Ochsner Clinic Foundation Hospital in New Orleans.
Nearly one in four cancer deaths in women in 2003 were expected to be from lung cancer. At the same time women's rates of lung cancer deaths have been increasing, they've been decreasing for men.
In their report, Patel and her colleagues explained that one reason for this difference may be that women are more susceptible to lung cancer than men. This is a controversial topic among researchers, however. Some studies have shown women are more prone to the disease, but others have failed to confirm these findings or have found the opposite to be true.
While it wasn't included in Patel's analysis, one of the most recent studies on the subject found female smokers had double the risk of lung cancer that male smokers do. Results of this study were presented in December 2003 at the annual meeting of the Radiological Society of North America.
The topic of women's susceptibility may still be controversial, but Patel said one thing that isn't is that there are biological differences in the way lung cancer acts in women than in men. For example, women tend to live longer than men after being diagnosed with lung cancer. That may be because lung cancer cells have more estrogen receptors than normal lung cells do, according to Patel, who added that more gender-specific lung cancer research needs to be done.
Despite the huge rise in lung cancer, and the knowledge that smoking causes other illnesses, the researchers noted that nearly one-quarter of all American women still smoke.
"Women need to realize that they can reduce their risk of cancer by one half if they don't smoke and they're not obese," Brooks says.
"We have to make smoking less socially acceptable," explained Patel, who said it's a difficult task because the tobacco industry spends billions of dollars per year on advertising and marketing, yet only about $100 million is spent on smoking cessation efforts.
Patel said it's especially important to get the message to other countries where female smoking rates are currently low, so they don't repeat the mistake.
"The tobacco industry sees a huge opportunity worldwide," said Dr. Michael Thun, head of epidemiological research for the American Cancer Society. Thun says Spain is an example of how tobacco marketing can work. He says that at the end of World War II, very few Spanish women smoked. But with the collapse of Franco's dictatorship, the tobacco industry marketed cigarettes using positive images coupling smoking with independence and freedom, and the rates of female smoking increased dramatically.
"Using images of liberation and democracy to ensnare women into smoking is a massive global problem, and it's appalling," Thun said. Brooks added that other tobacco marketing sends women the message that if you smoke, you will be thin.
Brooks recommended showing young women pictures of how they can prematurely age from smoking. Thun suggested appealing to a teen's sense of freedom and justice, and ask them, "Why would you want to be entrapped by a huge, lying industry?"
Finally, Thun pointed out, "Lung cancer, although a huge burden, is less than a third of all deaths that smoking causes."