Women who smoke appear to have a higher risk for lung cancer than men who smoke, although women smokers have a lower rate of lung cancer-related death, according to an article in the July 12 issue of the Journal of the American Medical Association.

In 2006 in the United States, it is estimated that lung cancer will cause 73,020 deaths in women, proportionately only slightly fewer than the estimated 90,470 deaths in men. Lung cancer now accounts for more deaths in women than any other cancer, more even than the second and third cancer killers (breast and colon cancer) combined, according to background information in the article.

Claudia I. Henschke, PhD, MD, of Cornell University, New York, and investigators with the International Early Lung Cancer Action Program examined the lung cancer risk of women compared with men, accounting for age and history of smoking, and also compared the rate of fatal outcomes between sexes.

The study included 7,498 women and 9,427 men at least 40 years of age who had a history of cigarette smoking and were screened for lung cancer in North America between 1993 and 2005.

Lung cancer was diagnosed in 156 women and 113 men (rates of 2.1 percent and 1.2 percent, respectively). The researchers also found that women had a lower rate of lung cancer-related death after adjustment for pack-years of smoking, disease stage, tumor cell type, and resection.

"If lung cancer risk for women who smoke is indeed higher than the risk for men of the same age who smoke, as indicated by the evidence presented here, this suggests that antismoking efforts directed toward girls and women need to be even more serious than those directed toward boys and men," the authors wrote.

In an accompanying editorial, Alfred I. Neugut, MD, PhD, and Judith S. Jacobson, DrPH, MBA, of Columbia University, New York, commented on the study by Henschke et al:
"The reasons women live with lung cancer longer than men are unclear. Do women fare better because of their body size, better health behaviors, hormonal and reproductive factors, different cigarette smoking histories or patterns, or other factors? Women's stage-for-stage advantage in survival appears to be a host effect and applies to all the major histological types of lung cancer."