Women at double risk of small cell lung cancer

BMJ 1998; 317 doi: (Published 12 December 1998) Cite this as: BMJ 1998;317:1614
  1. Zosia Kmietowicz
  1. London

    Women are nearly twice as likely as men to develop small cell lung cancer--which is the most aggressive form of the disease and which is often inoperable--according to the results of the largest study of patients with lung cancer yet to be carried out in the United Kingdom.

    The clinical features of more than 1000 patients with lung cancer presenting to 46 UK hospitals have been analysed as part of a study based at the Royal College of Physicians' Research Unit. The results of the analysis, which were presented at the winter meeting of the British Thoracic Society last week (2 December), showed that women under 65 are particularly at risk of small cell lung cancer--34% presented with this form of the disease compared to 18% of men. The risk of developing small cell lung cancer was higher among women than men in all age groups. Seven out of 10 cases were inoperable. In contrast, men were more likely to have non-small cell lung cancer, which is less serious; nearly half of the men in the study could be considered for surgery.

    Dr Mike Pearson, chairman of the British Thoracic Society Public Education Committee and lead investigator of the study, speculated that there may be a number of reasons for the differences between men and women. “There may be a genetic difference between men and women which makes women more prone to small cell lung cancer. Women could be smoking different cigarettes or they may be smoking them in a different way,” he said.

    “If people switch from a high to a low tar cigarette, they tend to suck in more deeply. This is associated with more particles getting into the lungs at great speed. These will impact on the bifurcations of the bronchi, which is where the cancer develops,” explained Dr Pearson. “Smoking more in the style of the cartoon character Andy Capp, who has a cigarette hanging out of his mouth and breathes in smoke as part of his normal breathing, may be less likely to lead to particle deposition and lung cancer.”

    The researchers hope that their findings will act as a deterrent to smoking among women. The number of teenage girls smoking in the United Kingdom increased from 1 in 5 in 1982 to 1 in 3 in 1996.

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    Research has shown double the risk of small cell lung cancer in women

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