Lung Cancer: Men vs. Women

When it comes to lung cancer, there are significant differences between the way men and women develop the disease as well as their response to treatment.

These differences are helpful to note especially when women look at statistics regarding lung cancer survival. Statistics usually lump men and women together, but for women, the chances of survival are higher at all stages of the disease.

We are just beginning to learn how genetic and hormonal influences play a role in the development of lung cancer and what might explain these differences. How do men and women differ in the development of and response to lung cancer? Let's take a look.

Incidence

Lung cancer is the leading cause of cancer deaths for women in the United States, accounting for almost twice as many deaths as breast cancer. The incidence of lung cancer is greater in men than in women, but women are catching up. In 2016 it was estimated that 117,920 men and 106,470 women would be diagnosed with lung cancer.

Smoking

Unlike men, a greater percentage of women that develop lung cancer have never smoked and roughly 20% of lung cancer deaths in women occur in lifelong non-smokers. In contrast, it's thought that only 1 in 12 men with lung cancer are never-smokers.

For both sexes, however, it's important to note that the majority of people diagnosed with lung cancer today are non-smokers. Instead, most people who develop lung cancer are former smokers or never-smokers rather than current smokers.

Another concerning issue is that lung cancer in non-smokers is increasing. This is not due to the change in proportions, but a true increase in the incidence of lung cancer in non-smokers.

Age

Women tend to be slightly younger, by an average of two years, at the age of diagnosis than men. While the average age of lung cancer in women is only slightly less, there are many more young women with lung cancer than young men.

Lung cancer in young adults is increasing—unlike lung cancer in older adults—and the increase is especially high in young, never-smoking women. Studies over the past few years suggest that estrogen may promote growth of lung tumors which may account for the earlier age of diagnosis in women.

Risk Factors

Some studies suggest that women are more susceptible to the carcinogens in cigarettes and develop lung cancer after fewer years of smoking. Other studies do not show an increased risk of lung cancer in women who smoke versus men who smoke.

There has also been a perception that lung cancer is more common in non-smoking women than non-smoking men, but this does not appear to be the case in more recent studies. Even though the percentage of non-smoking women who develop lung cancer is higher than men, women do not appear to be more sensitive to other lung cancer carcinogens, and this likely stems from a higher number of men versus women who smoked in the past.

Types

Women are more likely to have lung adenocarcinoma than other types of lung cancer. The incidence of lung adenocarcinoma is also increasing in men, but men are more likely than women to develop squamous cell carcinoma of the lungs and small cell lung cancer.

Molecular Profiling/Gene Testing

Women are also more likely to have identifiable genetic changes related to their cancer than men. This is important as many of the newer therapies—such as EGFR mutations, ALK, and ROS rearrangements—target these particular genetic changes. It's recommended that everyone with non-small cell lung cancer have gene profiling (molecular profiling) done on their tumors, but this is especially important in women for this reason.

Treatment

Women historically respond to a few chemotherapy medications used for lung cancer better than men. One of the newer targeted therapies, Tarceva (erlotinib), also appears to be more effective for women—especially younger women.

Survival

Women are more likely to survive lung cancer at all stages of the disease. This survival advantage over men is greatest for local disease, where surgical treatment of lung cancer offers a greater chance for a cure in women than in men.

Prevention

An ounce of prevention is worth a pound of cure. And there are many important ways in which lung cancer preventive efforts may vary between the sexes.

Since 80% of lung cancers in women are related to smoking, by far the most important step both women and men can take to reduce their risk is to quit smoking.

Lung cancer does occur in non-smoking women to a greater percentage than men, but many of these other exposures, such as radon in the home, are preventable, too.

A Word From Verywell

Though there are many gender differences when it comes to lung cancer, one issue is the same: stigma. Raising awareness that lung cancer occurs in men, women, and young adults is a good way of opening the public's eyes, but it is important to not create any divisions at the same time. 

While it can be helpful to point out some of these gender differences, it's essential to remember that anyone can get lung cancer and that everyone with lung cancer is important.