Lung cancer overtakes breast cancer in women



Sunday 24 September 2000

Press briefing 24th September 2000 immediate

 

Lung cancer overtakes breast cancer as a killer of women

 

Responding to the analysis from Cancer Research Campaign [1] showing that lung cancer in women has risen over the last 20 years whereas breast cancer is in decline, ASH highlighted the importance of the history of smoking since the 2nd World War in explaining the observations.

 

ASH said that the figures reflect the rise in female smoking up to the 60s with about a 30-year lag for the cancer rates to follow the rise in smoking.  In the UK, smoking among women peaked in 1966 at about 46% of adult women and has declined to around 26-28% over the next three decades (26% in 1998) [2]. The population smoking in 1966 would be the post-war baby-boomers and skewed towards the younger age group (older women were not taking up the habit,so the growth came from younger women). As that population has aged and continued to smoke, so the cancers associated with smoking have become evident.  Clive Bates, Director of ASH, said:

 

“We are seeing the consequences of the rise in smoking among women in the swinging sixties.  That’s the sad thing ­ what appears to be liberating and fun at the time, is ended in agonising distress in a terminal cancer ward.”

 

But there is a message of hope ­ we should see a decline in lung cancer that follows the decline in smoking rates after the 1960s – just as we have seen with men.  There has been a very marked decline in lung cancers among men (see chart below), and this follows the trend in male smoking, which reached a high point of almost 80% at the end of the 2nd world war and has decline to the roughly the same level as female smoking in the 1990s.

 

Male smoking peaked 20 years before women at a higher level and declined more sharply.  We have already seen a dramatic drop in male lung cancers.  The recent paper by Professor Sir Richard Peto and Professor Richard Doll illustrates this very clearly.

 

The chart below shows the rise and fall in lung cancer among men, and the steady rise among older women.

 

The other main difference between the factors driving breast cancer and lung cancer mortality among women is the success in treatment of breast cancer, which has steadily improved over the last twenty years and now offers good survival prospects.   In contrast, the five-year survival prognosis for lung cancer remains a pitifully low five percent ­ someone diagnosed with lung cancer has a 95% chance of being dead within five years.

 

 

ASH argues that the only real successful cure to lung cancer is to prevent it forming by quitting smoking.  Clive Bates of ASH said:

 

“Despite years of research into the cure for cancer, the situation is especially dire for lung cancer once you have it.  But we do actually know how to treat lung cancer ­ we have to catch it before it can even start, and that means treating the addiction to tobacco and nicotine that underpins smoking.

 

“Anyone smoking can reduce their lung cancer riskby quitting ­ the earlier you stop, the more you reduce the risk.

 

ASH is campaigning for greater involvement of the NHS in smoking cessation in the UK [3] ­ recognising that smoking cessation is a means of treating many serious diseases before the actually have chance to happen.  The Government recently announced new emphasis on the case for greater attention to smoking cessation in NHS.

 

 

More background information

 

  1. It was reported this morning that the rise in female lung cancer was attributable to increased smoking among women.  This is only half true!  The rise in lung cancer among women IS due to an increase in women’s smoking,BUT this rise happened in the 1950s and 60s.  The highest level of adult female smoking was in 1966 at 46 percent and there has been a steady decline since.

 

  1. The most recent statistics do not show a rise in adult women smoking in the UK(teenagers are too young to affect the lung cancer stats). 1998 adult female prevalence was 26 percent – the lowest since the 1940s.  There has been a steady decline since the 1960s, though this has slowed and may have bottomed-out in the 1990s.

 

  1. The high level of female lung cancer we are seeing now is attributable to the high level of smoking in the 1960s and earlier, and the aging of that cohort of women smokers- lung cancer trends generally follow smoking trends with a lag of about 30 years.

 

  1. We are probably over the worst with female lung cancer – the situation is unlikely to get worse and very likely to get better because we should start to see the benefits of the reduced female smoking since the 1960s feeding through into the lung cancer statistics.  Indeed data published in the BMJ in August suggests the peak for female lung cancer has already passed.

 

  1. This has been the pattern already observed with men – there has been a sharp drop in male lung cancer attributable to the reduction in male smoking in the post-war period.   Male smoking prevalence peaked higher and earlier (at about 80% in 1945) and declined more rapidly than female, and as a result male and female smoking prevalence have almost converged at around 26-28 percent.

 

  1. British men have always smoked more than women, though the gap has steadily closed, and always had a higher death rate from lung cancer than women – of 30,000 smoking-related lung cancer deaths in 1995, about two-thirds were men and one-third women.

 

  1. There WAS a sharp rise in smoking among teenagers, especially girls, in the early 1990s -but these smokers are too young to have any impact on the lung cancer statistics.  There has in any case been a sharp FALL in teenage smoking since 1996 which was the high water mark.  For girls age 15, 33 percent smoked in 1996.  In 1999 it was down to 25 percent.  (Boys 29% and 21%respectively – the difference between boys and girls is mostly timing.  By late teens the differences are ironed out)

 

  1. The main factors accounting for lung cancers surpassing breast cancer as a killer of women are:

 

  1. Changes indominant causal factor – historical changes in smoking prevalence as discussedabove

 

  1. Changes indetection and treatment – which are greatly improved for breast cancer butdismal and largely unchanged for lung cancer

 

 

Press Contact: Clive Bates 020 7739 5902 (w) 0468 791 237 (m) ISDN is available

 

[1]Cancer Research Campaign provides funding for ASH as part of its efforts to reduce smoking, and hence lung cancer, in society.

 

[2]Figures from Office for National Statistics (ONS) 1999.

 

[3]See ASH smoking cessation resources at www.ash.ork.uk/?cessation