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Lung Cancer among Women -- Canada

From 1932 to 1981, the age-standardized mortality rates (ages 25-74 years) for lung cancer among Canadian women increased from 2.8/100,000 to 25.1/100,000. This is the most rapidly increasing cancer rate among women, and lung cancer rates for Canadian women have risen from ninth position in 1965 to second in 1981 (Table 1). Since this increase has shown an exponential rise, and breast cancer mortality has tended to decrease (Figure 1), lung cancer can be expected to become the leading cause of cancer death for Canadian women by about 1987. Furthermore, because the lung cancer mortality rates among males are gradually slowing, lung cancer mortality rates for females may equal those for males by 2000 (1).

The risk of developing lung cancer is strongly associated with smoking. A survey of smoking habits by the Canada Labour Force showed that changes in smoking habits of Canadian women are related to the increased lung cancer rate:

  1. From 1965 to 1979, the proportion of regular women smokers was constant, but the proportion of heavy smokers (25 or more cigarettes/day) increased continuously.

  2. In the province of British Columbia, the proportion of heavy smokers rose before other provinces, and was reflected by an earlier trend in the rapid increase of lung cancer mortality among women in British Columbia. The proportion of heavy smokers in British Columbia remains higher

than in the other Canadian provinces and is reflected by a faster increasing rate of lung cancer among British Columbian women than among women in the rest of Canada. In some provinces, the proportion of regular smokers continues to decrease, despite increases in the proportion of heavy smokers and in the average number of cigarettes consumed per day. Reported in Chronic Diseases in Canada (1983;4:32-4) by Y Mao, H Smith, Non-Communicable Disease Div, Bureau of Epidemiology, Laboratory Centre for Disease Control, Health and Welfare Canada; Office of the Director, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: The lung cancer epidemic among women is also occurring in the United States (Figure 2). The American Cancer Society estimates that 36,000 women will die in the United States from lung cancer in 1984. This approaches the 37,300 estimated deaths from breast cancer, which has been the primary cause of cancer mortality among U.S. women (2). In at least two states, Kentucky and Washington, lung cancer deaths have exceeded breast cancer deaths among women (3,4).

Approximately 85% of all lung cancer cases are attributable to cigarette smoking (5). The lung cancer epidemic is especially tragic because it is preventable. Increased focus on the health problems of smoking among women and on the potential for effective intervention is needed (6).

References

  1. Stolley PD. Lung cancer in women--five years later, situation worse. N Engl J Med 1983;309:428-9.

  2. Silverberg E. Cancer statistics, 1984. Ca--A Cancer J Clinicians 1984;34:7-23.

  3. Kentucky Cabinet for Human Resources. Selected cancer deaths. State Center for Health Statistics. 1981 annual vital statistics report;1983:478.

  4. Starzyk PM. Lung-cancer deaths: equality by 2000? N Engl J Med 1983;308:1289-90.

  5. Office on Smoking and Health. The health consequences of smoking: cancer. A report of the Surgeon General. Rockville, Maryland: Public Health Service, U.S. Department of Health and Human Services, 1982.

  6. Office on Smoking and Health. The health consequences of smoking for women. A report of the Surgeon General. Rockville, Maryland: Public Health Service, U.S. Department of Health and Human Services, 1980.

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