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Gender may render women at risk for lung cancer.

Skyrocketing lung cancer deaths in women since 1950 may be due to more than increased smoking. A new study suggests that women may be more susceptible to DNA-damaging carcinogens than men. In a retrospective analysis of lung cancer cases between 1981 and 1994, researchers at the American Health Foundation in New York found that women's susceptibility to lung cancer may go beyond their exposure to smoking — the leading cause of this type of cancer. Results of the study appear in this issue of the Journal (see page 183). "I believe that it is likely — conceptually — that there is an endogenous factor that increases a woman's risk," said Ernst L. Wynder, M.D., a principal investigator of the study and president of the New York foundation. Wynder and his co-investigator, Edith A. Zang, Ph.D., offer several possible explanations for the gender gap: hormonal factors, particularly estrogen, and differences in how women process and detoxify carcinogens, including those in tobacco smoke. 'The main point here is that women begin smoking later than men, they smoke fewer and lighter [tar] cigarettes than men . . . and yet they have a higher Dr. Ernst L. Wynder risk of developing lung cancer," Wynder said. "Our paper is saying that we cannot afford to ignore this epidemic of lung cancer in women." Since 1987, lung cancer has been the leading cause of cancer death in women, surpassing breast cancer. And while lung cancer incidence has leveled off among men, it continues to rise steadily among women. This increase in incidence, Wynder and Zang contend, "exceeds that expected from a slower decline of smoking among women."