Women have caught up to men on lung cancer risk

By MARILYNN MARCHIONE

AP Chief Med­ical Writer

Smoke like a man, die like a man.

U.S. women who smoke today have a much greater risk of dying from lung can­cer than they did decades ago, partly because they are start­ing younger and smok­ing more — that is, they are light­ing up like men, new research shows.

Women also have caught up with men in their risk of dying from smoking-related ill­nesses. Lung can­cer risk lev­eled off in the 1980s for men but is still ris­ing for women.

“It’s a mas­sive fail­ure in pre­ven­tion,” said one study leader, Dr. Michael Thun of the Amer­i­can Can­cer Soci­ety. And it’s likely to repeat itself in places like China and Indone­sia where smok­ing is grow­ing, he said. About 1.3 bil­lion peo­ple world­wide smoke.

The research is in Thursday’s New Eng­land Jour­nal of Med­i­cine. It is one of the most com­pre­hen­sive looks ever at long-term trends in the effects of smok­ing and includes the first gen­er­a­tion of U.S. women who started early in life and con­tin­ued for decades, long enough for health effects to show up.

The U.S. has more than 35 mil­lion smok­ers — about 20 per­cent of men and 18 per­cent of women. The per­cent­age of peo­ple who smoke is far lower than it used to be; rates peaked around 1960 in men and two decades later in women.

Researchers wanted to know if smok­ing is still as deadly as it was in the 1980s, given that cig­a­rettes have changed (less tar), many smok­ers have quit, and treat­ments for many smoking-related dis­eases have improved.

They also wanted to know more about smok­ing and women. The famous sur­geon general’s report in 1964 said smok­ing could cause lung can­cer in men, but evi­dence was lack­ing in women at the time since rel­a­tively few of them had smoked long enough.

One study, led by Dr. Prab­hat Jha of the Cen­ter for Global Health Research in Toronto, looked at about 217,000 Amer­i­cans in fed­eral health sur­veys between 1997 and 2004.

A sec­ond study, led by Thun, tracked smoking-related deaths through three peri­ods — 1959–65, 1982–88 and 2000-10 — using seven large pop­u­la­tion health sur­veys cov­er­ing more than 2.2 mil­lion people.

Among the findings:

— The risk of dying of lung can­cer was more than 25 times higher for female smok­ers in recent years than for women who never smoked. In the 1960s, it was only three times higher. One rea­son: After World War II, women started tak­ing up the habit at a younger age and began smok­ing more.

—A per­son who never smoked was about twice as likely as a cur­rent smoker to live to age 80. For women, the chances of sur­viv­ing that long were 70 per­cent for those who never smoked and 38 per­cent for smok­ers. In men, the num­bers were 61 per­cent and 26 percent.

—Smok­ers in the U.S. are three times more likely to die between ages 25 and 79 than non-smokers are. About 60 per­cent of those deaths are attrib­ut­able to smoking.

—Women are far less likely to quit smok­ing than men are. Among peo­ple 65 to 69, the ratio of for­mer to cur­rent smok­ers is 4-to-1 for men and 2-to-1 for women.

—Smok­ing shaves more than 10 years off the aver­age life span, but quit­ting at any age buys time. Quit­ting by age 40 avoids nearly all the excess risk of death from smok­ing. Men and women who quit when they were 25 to 34 years old gained 10 years; stop­ping at ages 35 to 44 gained 9 years; at ages 45 to 54, six years; at ages 55 to 64, four years.

—The risk of dying from other lung dis­eases such as emphy­sema and chronic bron­chi­tis is ris­ing in men and women, and the rise in men is a sur­prise because their lung can­cer risk lev­eled off in 1980s.

Changes in cig­a­rettes since the 1960s are a “plau­si­ble expla­na­tion” for the rise in non-cancer lung deaths, researchers write. Most smok­ers switched to cig­a­rettes that were lower in tar and nico­tine as mea­sured by tests with machines, “but smok­ers inhaled more deeply to get the nico­tine they were used to,” Thun said. Deeper inhala­tion is con­sis­tent with the kind of lung dam­age seen in the ill­nesses that are ris­ing, he said.

Sci­en­tists have made scant progress against lung can­cer com­pared with other forms of the dis­ease, and it remains the lead­ing cause of can­cer deaths world­wide. More than 160,000 peo­ple die of it in the U.S. each year.

The fed­eral gov­ern­ment, the Cana­dian Insti­tutes of Health Research, the Bill and Melinda Gates Foun­da­tion, the can­cer soci­ety and sev­eral uni­ver­si­ties paid for the new stud­ies. Thun tes­ti­fied against tobacco com­pa­nies in class-action law­suits chal­leng­ing the sup­posed ben­e­fits of cig­a­rettes with reduced tar and nico­tine, but he donated his pay­ment to the can­cer society.

Posted by Becky Brooks on Jan 23 2013. You can follow any responses to this entry through the RSS Feed. Both comments and pings are currently closed.