Closing the gender gap.

Top Line: In med school we learned to hear lung cancer and picture a man who smokes. A lot. It’s time for an update on lung cancer epidemiology.
The Study: We’re winning the fight against lung cancer...right? In 2018 we’re enjoying new immunotherapies, targeted agents, and reduced rates of smoking (minus the vaping). So let’s take the pulse of current lung cancer demographics. This study examines the incidence of new lung cancer cases from 1995 to 2014 using data from the National Association of Central Cancer Registries. The prevalence of smoking over the same time was evaluated using the separate National Health Interview Survey, which didn’t link smoking status with cancer diagnoses. The primary outcome was the female : male ratio of incident lung cancer. Consistent with other large studies, the incidence of lung cancer has declined over the past two decades. Unfortunately, this is driven largely by a decline among men. Among women in their 30s-50s, the incidence of lung cancer is remarkably now higher than in men, specifically among white and hispanic subjects. Incidence rates per 100K among people 40-45 years old born in 1950 → 1965 plummeted from 37 → 23 for men while rolling over from 27 → 25 for women. What’s more, this can’t be explained by changes in smoking prevalence or behavior between men and women. In other words, what was once a rather uniform disease of male smokers is becoming increasingly complex from both social and biological standpoints.
Bottom Line: While rates of lung cancer are dropping, it’s face is changing as highlighted by a big increase in relative incidence of lung cancer among women born since 1960. | Jemal, N Engl J Med 2018

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