Why Are Women Getting More Lung Cancer Than Men?

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By Stewart Lonky, M.D.

Here’s something you might not know: Lung cancer is the leading cause of cancer death in women in developed countries, killing more women each year than breast, ovarian, and uterine cancer combined. 

Indeed, researchers from the American Cancer Society and the National Cancer Institute have confirmed that lung cancer rates are higher in young women (born after 1965) than younger men. 

These findings surprised many physicians and researchers because historically, lung cancer rates have been higher in men. Another surprise is that differences in smoking patterns alone couldn’t account for the change. As many as 20 percent of lung cancer deaths in the United States occur in women who never smoked or used any other form of tobacco. 

In fact, if lung cancer in both female and male non-smokers had its own separate category, it would rank among the top 10 fatal cancers in the United States.

Historically, US women are less likely to smoke, start smoking at older ages, and smoke fewer cigarettes per day than men, the higher lung cancer rates are shocking. However, in recent years, smoking behaviors among women have become similar to men.

Yet, the researchers found that smoking patterns among women did not fully explain the change in lung cancer incidence rates. 

Some researchers believe that women may be more susceptible than men to the health hazards of cigarette smoking. Another possibility is that women may be more likely than men to get lung cancer even after quitting smoking.

Researchers are still at a loss to explain why more non-smoking, non-tobacco using women are developing lung cancer. For nonsmokers between the ages of 40 and 79, more women than men are at risk for developing lung cancer. The latest data show an incidence rate in nonsmoking women ranging from 14.4 to 20.8 percent. For nonsmoking men, the rate is between 4.8 and 13.7 percent.

It’s not clear whether the causes are environmental, hormonal, or genetic. I suspect that secondhand smoke and high radon levels, as well as family history, can also raise the risk. To date, researchers haven’t been able to pinpoint a particular gene that might raise a woman's lung cancer risk. However, we do know that having a sibling or parent with lung cancer also increases risk, as it does for many other cancer types. Clearly, more research is needed.

Whatever the answer, it’s crucial that women be aware of lung cancer flags such as persistent shortness of breath, an incessant cough, fever, and overwhelming fatigue. 

Sources: American Cancer Society, Johns Hopkins Medicine

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