Press briefing
Lung cancer overtakes breast cancer as a killer of women
Respondingto the analysis from Cancer Research Campaign [1] showing thatlung cancer in women has risen over the last 20 years whereas breast cancer isin decline, ASH highlighted the importance of the history of smoking since the2nd World War in explaining the observations.
ASH saidthat the figures reflect the rise in female smoking up to the 60s with about a30-year lag for the cancer rates to follow the rise in smoking. In the UK, smoking among women peaked in1966 at about 46% of adult women and has declined to around 26-28% over thenext three decades (26% in 1998) [2]. The population smoking in 1966 would be the post-war baby-boomers andskewed 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 cancersassociated with smoking have become evident. Clive Bates, Director of ASH, said:
“Weare seeing the consequences of the rise in smoking among women in the swingingsixties. That's the sad thing whatappears to be liberating and fun at the time, is ended in agonising distress ina terminal cancer ward.”
Butthere is a message of hope we should see a decline in lung cancer thatfollows the decline in smoking rates after the 1960s - just as we have seenwith men. There has been a very markeddecline in lung cancers among men (see chart below), and this follows the trendin male smoking, which reached a high point of almost 80% at the end of the 2ndworld war and has decline to the roughly the same level as female smoking inthe 1990s.
Malesmoking peaked 20 years before women at a higher level and declined moresharply. We have already seen adramatic drop in male lung cancers. Therecent paper by Professor Sir Richard Peto and Professor Richard Doll:
Thechart below shows the rise and fall in lung cancer among men, and the steadyrise among older women.
The other main difference between thefactors driving breast cancer and lung cancer mortality among women is thesuccess in treatment of breast cancer, which has steadily improved over thelast twenty years and now offers good survival prospects. In contrast, the five-year survivalprognosis for lung cancer remains a pitifully low five percent someonediagnosed with lung cancer has a 95% chance of being dead within five years.
ASHargues that the only real successful cure to lung cancer is to prevent itforming by quitting smoking. CliveBates of ASH said:
“Despite years of research into the cure forcancer, the situation is especially dire for lung cancer once you have it. But we do actually know how to treat lungcancer we have to catch it before it can even start, and that means treatingthe 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 involvementof the NHS in smoking cessation in the UK [3] recognising that smokingcessation is a means of treating many serious diseases before the actually havechance to happen. The Governmentrecently announced new emphasis on smoking cessation in the NHSNational Plan the case for greater attentionto smoking cessation in NHS.
More background information
1. It wasreported this morning that the rise in female lung cancer was attributable toincreased 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 adultfemale smoking was in 1966 at 46 percent and there has been a steady declinesince.
2. The mostrecent 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 femaleprevalence was 26 percent - the lowest since the 1940s. There has been asteady decline since the 1960s, though this has slowed and mayhave bottomed-out in the 1990s.
3. The high levelof female lung cancer we are seeing now is attributable to the high level ofsmoking 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 30years.
4. We areprobably over the worst with female lung cancer - the situation is unlikely toget worse and very likely to get better because we should start to see thebenefits of the reduced female smoking since the 1960s feeding through into thelung cancer statistics. Indeed data published in the BMJ in Augustsuggests the peak for female lung cancer has already passed see Peto and Doll -
5. This hasbeen the pattern already observed with men - there has been a sharp drop inmale lung cancer attributable to the reduction in male smoking in the post-warperiod. Male smoking prevalence peaked higher and earlier (atabout 80% in 1945) and declined more rapidly than female, and as a result maleand female smoking prevalence have almost converged at around 26-28 percent.
6. British menhave always smoked more than women, though the gap has steadily closed, andalways had a higher death rate from lung cancer than women - of 30,000 smoking-relatedlung cancer deaths in 1995, about two-thirds were men and one-third women.
7. There WAS asharp 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. Therehas in any case been a sharp FALL in teenage smoking since 1996 whichwas the high water mark. For girls age 15, 33 percent smoked in1996. In 1999 it was down to 25 percent. (Boys 29% and 21%respectively - the difference between boys and girls is mostly timing. Bylate teens the differences are ironed out)
8. The mainfactors accounting for lung cancers surpassing breast cancer as a killer ofwomen are:
a. Changes indominant causal factor - historical changes in smoking prevalence as discussedabove
b. 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 isavailable
[1]Cancer Research Campaign provides funding for ASH as part of its efforts toreduce smoking, and hence lung cancer, in society.
[2]Figures from Office for National Statistics (ONS) 1999.
[3]See ASH smoking cessation resources at
