Lung cancer in women: differences in epidemiology, biology, histology, and treatment outcomes

Lung cancer is a major health problem for both men and women, not only because of the high incidence rate but, more alarming, the high mortality rate. The prevalence of lung cancer in women has been increasing worldwide. In the United States, lung cancer is currently the leading cause of cancer death in women, and this may well be the case in European countries in just a few years. The most important risk factors for the development of lung cancer in both men and women is cigarette smoking. Smoking among women has increased significantly since the 1960s, and, unfortunately, the risk of death from cigarette smoking continues to increase among women. Although epidemiological data remain controversial regarding the increased risk of lung cancer from tobacco exposure in women, there is little controversy surrounding the fact that the biology of lung cancer differs between the sexes. This paper summarizes the explanations for the sex differences in lung cancer, including differences in molecular abnormalities, growth factor receptors, hormonal influences, cytochrome P-450 enzymes, and DNA repair capacity, as well as differences in the histology of lung cancer and treatment outcomes in women.