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Tobacco a Gender Equalizer for Lung-Cancer Risk

And pipe smoking isn't a safe alternative to cigarettes, new studies show

TUESDAY, June 1, 2004 (HealthDayNews) -- Conventional wisdom holds that women are more likely than men to get lung cancer from smoking, but a new study says that just isn't so.

A Harvard University research team has found new evidence that women and men who have similar smoking histories share the same risk of developing lung cancer.

The report, which included 85,000 men and women, appears in the June 2 issue of the Journal of the National Cancer Institute.

"There has been a lot of thought in the past that women might be more susceptible to the carcinogens in smoke," said co-author Diane Feskanich, an assistant professor of medicine at Harvard.

"So even if women smoked less, they would be just as likely to get cancer. But we didn't find that in our study, which actually looked at rates of lung cancer in large groups of men and women," she added.

Using data from 1986 through 2000, Feskanich's team identified 955 cases of lung cancer among 60,296 women and 311 cases among 25,397 men.

This translates into lung cancer rates for current smokers of 253 cases per 100,000 for women and 232 cases per 100,000 for men. Among former smokers, the lung cancer rates were 81 per 100,000 for women and 73 per 100,000 for men, according to the study.

Feskanich believes that the myth that women are more susceptible to lung cancer started as more women began to smoke and their rates of lung cancer also rose. Basically, the increase in women's lung cancer rates reflected statistics, not biology, she said.

Based on these findings, Feskanich thinks there's no need to put more money into teasing out the differences in lung cancer rates between men and women.

"We need to have the same concern for smoking in men and women," she said. "The obvious answer is to stop smoking, but that's been obvious for a long time."

William J. Blot, of the International Epidemiology Institute and co-author of an accompanying editorial in the journal, said reports began to surface about 20 years ago that women were more susceptible to lung carcinogens. "But the data hasn't been clear," he said.

"This new report pretty much puts the nail in the coffin, and closes this lingering myth," he added.

Blot said if you smoke, you place yourself at risk whether you're a man or a woman.

"Smoking is the main cause of lung cancer, which is typically a fatal cancer, and whether you're male or female it doesn't matter very much," he said.

In another report in the same issue of the journal, Jane Henley of the American Cancer Society and colleagues found that pipe smoking is as dangerous as cigar smoking.

In this study, the researchers collected data on 138,307 men -- 15,263 of whom were current or former pipe users, and 123,044 who had never used tobacco. The men were followed for 18 years. During this period, 23,589 of the men died.

The researchers found that people who smoked pipes were five times more likely to get cancer of the colon/rectum, esophagus, larynx, lung, oropharynx, and pancreas, compared with people who never smoked. Pipe smokers also had about a 30 percent increased risk for developing coronary heart disease, cerebrovascular disease, and chronic obstructive pulmonary disease.

These risks were less than those linked with cigarette smoking, Henley said, "but similar or higher than those associated with cigar smoking."

"These results show that all tobacco products cause excessive morbidity," she added.

Henley said the tobacco industry has been successful in reviving markets that appeared to be obsolete, such as cigar smoking. "One way they have done this is by saying that these tobacco products aren't as harmful as cigarettes," she said.

"The point is that all tobacco products do cause adverse health effects," Henley said.

The latest findings come on the heels of a new report from U.S. Surgeon General Richard Carmona that linked a long list of diseases -- including acute myeloid leukemia and cancers of the kidney, cervix, stomach and pancreas -- to the catalog of serious health problems caused by smoking.

Abdominal aortic aneurysm, pneumonia, periodontitis and cataracts are also among the diseases now linked to smoking, the report, released last week, said.

More information

The American Cancer Society has more about lung cancer.

SOURCES: Diane Feskanich, Sc.D., assistant professor of medicine, Harvard University; William J. Blot, Ph.D., International Epidemiology Institute, Rockville, Md.; Jane Henley, MSPH, epidemiologist, American Cancer Society, Atlanta; June 2, 2004, Journal of the National Cancer Institute
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