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Current Trends Lung Cancer and Breast Cancer Trends Among Women -- Texas

In 1982, lung cancer equaled breast cancer as the leading cause of cancer death among Texas women (Figure 1).* For 1970-1982, the age-adjusted** lung cancer mortality rate per 100,000 women almost doubled from 11.9 to 22.6, and the proportion of deaths from malignant neoplasms attributed to lung cancer increased from 9.7% to 17.4%. During the same period, breast cancer mortality rates and the proportion of total malignant neoplasm deaths attributed to breast cancer remained stable (Table 3).

The highest age-adjusted*** lung cancer rates and those with the steepest increases occurred among Texas women 65 years of age and older; the rate rose from 52.0/100,000 in 1970 to 110.1/100,000 in 1982. Because 85% of all lung cancer deaths in the United States are attributable to cigarette smoking, the increasing rate for older Texas women can be related to the increasing number of women in this age cohort who began smoking cigarettes in the 1930s and 1940s (1). Reported by V Guinee, MD, G Giocco, MS, MD Anderson Hospital and Tumor Institute, University of Texas System Cancer Center, Houston, L Suarez, MS, WD Carroll, MPH, WE Barrington, MPH, A Menchetti, CE Alexander, MD, State Epidemiologist, Texas Dept of Health; Div of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Div of Field Svcs, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: Based on the historic increase in the exposure of U.S. women to tobacco, an epidemic of lung cancer has been predicted (1,2). Although breast cancer remains the leading cause of cancer death among U.S. and Canadian women, a steady rise in the long-term secular trend of lung cancer mortality rates has been observed in both countries (1,3). In at least two states, the recent predominance of lung cancer over breast cancer has been documented through reviews of age-adjusted mortality rates (4,5).

In 1982, 27% of Texas women surveyed reported currently smoking cigarettes, and 42% reported having smoked at least 100 cigarettes at some time (6). These data point to the continuing need for public health intervention to reduce smoking and the burden of cancer related to it.

While cigarette smoking is the single most important cause of lung cancer, the increase over the past 50 years in the number of U.S. women in the industrial workforce increases the likelihood of exposure to occupational carcinogens. Occupational agents associated with lung cancer include arsenic, asbestos, chloroethers, chromates, ionizing radiation, nickel, and polynuclear aromatic hydrocarbon compounds. The risk of lung cancer may be sharply increased as cigarette smoking interacts synergistically with some of these agents (e.g., asbestos) (7).

References

  1. 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.

  2. Doll R, Peto R. The causes of cancer. Quantitative estimates of avoidable risks of cancer in the United States today. New York: Oxford University Press, 1981.

  3. CDC. Lung cancer among women--Canada. MMWR 1984;33:67-9.

  4. Kentucky Cabinet for Human Resources. The rising epidemic of lung cancer among Kentucky women. Kentucky Epidemiology Notes and Reports 1983;18.

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

  6. Texas Department of Health. Texas behavioral risk factor survey: an overview. 1982.

  7. CDC. Leading work-related diseases and injuries--United States: occupational lung diseases. MMWR 1983;32:24-6, 32. *Rates determined from death certification International Classification of Diseases (ICD) categories 162 (lung cancer) and 174 (breast cancer). **Age-adjusted by 5-year age groups using the total 1970 U.S. population as a standard. ***Age-adjusted by 5-year age groups using the 1970 U.S. population 65 years and older as a standard.



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