E Quoix1, B Mennecier. 1. Hôpitaux Universitaires de Strasbourg, Service de Pneumologie, Strasbourg, France. elisabeth.quoix@chru-strasbourg.fr
Abstract
BACKGROUND: Since the end of the 1980's, there has been a significant increase in the incidence of lung cancer in women in France. This is largely due to an increase in women smoking since the end of the nineteen-sixties, some 20 years later than occurred in North America. STATE OF THE ART: Since 1995 lung cancer has been the third most common malignant cause of death in French women having become the most common in The United States in 1987. The epidemiology of the disease in women is different, with tobacco smoking explaining only 70% of the incidence. Moreover, even if smoking is the primary cause of lung cancer, the reported duration and amount smoked is generally speaking lower than in men with equivalent disease. Other risk factors such as higher expression of the gastrin-releasing peptide (GRP) receptor, hormonal factors, radon and passive smoking may also play a role. The distribution of histological types is also different in women, with a predominance of adenocarcinomas. Finally, prognosis appears to be better in women. PERSPECTIVES: Targeted therapies have introduced another gender distinction since women are more likely to respond to gefitinib and erlotinib than men. CONCLUSION: The massive increase in lung cancer in women is the most important epidemiological feature of recent years. Due to some differences in risk factors, histology distribution, prognosis and therapeutic response, specific studies devoted to female patients especially non-smokers are needed.
BACKGROUND: Since the end of the 1980's, there has been a significant increase in the incidence of lung cancer in women in France. This is largely due to an increase in women smoking since the end of the nineteen-sixties, some 20 years later than occurred in North America. STATE OF THE ART: Since 1995 lung cancer has been the third most common malignant cause of death in French women having become the most common in The United States in 1987. The epidemiology of the disease in women is different, with tobacco smoking explaining only 70% of the incidence. Moreover, even if smoking is the primary cause of lung cancer, the reported duration and amount smoked is generally speaking lower than in men with equivalent disease. Other risk factors such as higher expression of the gastrin-releasing peptide (GRP) receptor, hormonal factors, radon and passive smoking may also play a role. The distribution of histological types is also different in women, with a predominance of adenocarcinomas. Finally, prognosis appears to be better in women. PERSPECTIVES: Targeted therapies have introduced another gender distinction since women are more likely to respond to gefitinib and erlotinib than men. CONCLUSION: The massive increase in lung cancer in women is the most important epidemiological feature of recent years. Due to some differences in risk factors, histology distribution, prognosis and therapeutic response, specific studies devoted to female patients especially non-smokers are needed.