This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (72)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Pulmonary Diseases, Other  • Genetic Counseling/ Testing/ Therapy  • Women's Health, Other  • Oncology  • Lung Cancer  • Alert me on articles by topic

A Contemporary Epidemic

Jyoti D. Patel, MD; Peter B. Bach, MD; Mark G. Kris, MD

JAMA. 2004;291:1763-1768.

Lung cancer is the leading cause of cancer death in US women and is responsible for as many deaths as breast cancer and all gynecological cancers combined. Most lung cancer is caused by cigarette smoke. Despite all that is known about the devastating effects of cigarettes, one quarter of women in the United States continue to smoke. Women are targeted in tobacco advertising, and teenage girls are often drawn to cigarette smoking under a variety of social pressures.

Following the increase in smoking, the death rate from lung cancer in US women rose 600% from 1930 to 1997. Women may be more susceptible than men to the carcinogenic properties of cigarette smoke. In addition, differences in the biology of lung cancer exist between the 2 sexes with higher levels of DNA adduct formation, increased CYP1A1 expression, decreased DNA repair capacity, and increased incidence of K-ras gene mutations in women. The novel estrogen receptor has also been detected in lung tumors and suggests that estrogen signaling may have a biological role in tumorigenesis. Given these differences and given the enormous toll this disease has on US women, undertaking sex-specific research in lung cancer is crucial. Finally, disseminating information about this epidemic may prevent a similar epidemic in other parts of the world where women are just now becoming addicted to tobacco.

Author Affiliations: Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, and the Robert H. Lurie Comprehensive Cancer Center, Chicago, Ill (Dr Patel); The Health Outcomes Research Group, Department of Epidemiology and Biostatistics (Dr Bach) and Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center (Dr Kris) and Department of Medicine, Weill Medical College of Cornell University (Dr Kris), New York, NY.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Factors Associated with Human Small Aggressive Non Small Cell Lung Cancer
Tammemagi et al.
Cancer Epidemiol. Biomarkers Prev. 2007;16:2082-2089.
ABSTRACT | FULL TEXT  

The Growing Burden of Chronic Obstructive Pulmonary Disease and Lung Cancer in Women: Examining Sex Differences in Cigarette Smoke Metabolism
Ben-Zaken Cohen et al.
Am. J. Respir. Crit. Care Med. 2007;176:113-120.
ABSTRACT | FULL TEXT  

Sex Differences in Lung Cancer Survival: Do Tumors Behave Differently in Elderly Women?
Wisnivesky and Halm
JCO 2007;25:1705-1712.
ABSTRACT | FULL TEXT  

Detection of Pre-Invasive Lung Cancer: Technical Aspects of the LIFE Project
Flake et al.
Toxicol Pathol 2007;35:65-74.
ABSTRACT  

Women and lung cancer: gender equality at a crossroad?
Neugut and Jacobson
JAMA 2006;296:218-219.
FULL TEXT  

Serum cotinine level as predictor of lung cancer risk.
Boffetta et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:1184-1188.
ABSTRACT | FULL TEXT  

Never-Smokers With Lung Cancer: Epidemiologic Evidence of a Distinct Disease Entity
Toh et al.
JCO 2006;24:2245-2251.
ABSTRACT | FULL TEXT  

Lung cancer death rates in lifelong nonsmokers.
Thun et al.
JNCI J Natl Cancer Inst 2006;98:691-699.
ABSTRACT | FULL TEXT  

Prevalence of COPD in Women Compared to Men Around the Time of Diagnosis of Primary Lung Cancer
Loganathan et al.
Chest 2006;129:1305-1312.
ABSTRACT | FULL TEXT  

Gender difference in the activity but not expression of estrogen receptors {alpha} and {beta} in human lung adenocarcinoma cells.
Dougherty et al.
Endocr Relat Cancer 2006;13:113-134.
ABSTRACT | FULL TEXT  

Aromatase Inhibitors in Human Lung Cancer Therapy
Weinberg et al.
Cancer Res. 2005;65:11287-11291.
ABSTRACT | FULL TEXT  

Analysis of Orthologous Gene Expression between Human Pulmonary Adenocarcinoma and a Carcinogen-Induced Murine Model
Stearman et al.
Am. J. Pathol. 2005;167:1763-1775.
ABSTRACT | FULL TEXT  

ESTROUS CYCLE ALTERS NAPHTHALENE METABOLISM IN FEMALE MOUSE AIRWAYS
Stelck et al.
Drug Metab. Dispos. 2005;33:1597-1602.
ABSTRACT | FULL TEXT  

Lung Cancer in Women: Emerging Differences in Epidemiology, Biology, and Therapy
Thomas et al.
Chest 2005;128:370-381.
ABSTRACT | FULL TEXT  

Relationship between reduced forced expiratory volume in one second and the risk of lung cancer: a systematic review and meta-analysis
Wasswa-Kintu et al.
Thorax 2005;60:570-575.
ABSTRACT | FULL TEXT  

Lung Cancer Screening
Mulshine and Sullivan
NEJM 2005;352:2714-2720.
FULL TEXT  

Mortality From Lung Cancer and Tobacco Smoking in Ohio (U.S.): Will Increasing Smoking Prevalence Reverse Current Decreases in Mortality?
Tyczynski and Berkel
Cancer Epidemiol. Biomarkers Prev. 2005;14:1182-1187.
ABSTRACT | FULL TEXT  

Emotions for sale: cigarette advertising and women's psychosocial needs
Anderson et al.
Tobacco Control 2005;14:127-135.
ABSTRACT | FULL TEXT  

Clinical and Biological Features Associated With Epidermal Growth Factor Receptor Gene Mutations in Lung Cancers
Shigematsu et al.
JNCI J Natl Cancer Inst 2005;97:339-346.
ABSTRACT | FULL TEXT  

Contemporary Lung Cancer Trends among U.S. Women
Jemal et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:582-585.
ABSTRACT | FULL TEXT  

Pivotal Study of Iodine-131-Labeled Chimeric Tumor Necrosis Treatment Radioimmunotherapy in Patients With Advanced Lung Cancer
Chen et al.
JCO 2005;23:1538-1547.
ABSTRACT | FULL TEXT  

Combined Targeting of the Estrogen Receptor and the Epidermal Growth Factor Receptor in Non-Small Cell Lung Cancer Shows Enhanced Antiproliferative Effects
Stabile et al.
Cancer Res. 2005;65:1459-1470.
ABSTRACT | FULL TEXT  

The Beta-Carotene and Retinol Efficacy Trial: Incidence of Lung Cancer and Cardiovascular Disease Mortality During 6-Year Follow-up After Stopping {beta}-Carotene and Retinol Supplements
Goodman et al.
JNCI J Natl Cancer Inst 2004;96:1743-1750.
ABSTRACT | FULL TEXT  

The Changing Face of Lung Cancer
Barnes
Chest 2004;126:1718-1721.
FULL TEXT  

Benchmarking Lung Cancer Mortality Rates in Current and Former Smokers
Bach et al.
Chest 2004;126:1742-1749.
ABSTRACT | FULL TEXT