Sex-specific trends in lung cancer incidence and survival: a population study of 40 118 cases

Abstract

Background and aim Lung cancer is increasingly affecting women. The aim of this study was to identify sex-specific trends in lung cancer incidence and survival. Methods Complete national data on 40 118 cases from the Cancer Registry of Norway sampled from 1988 to 2007 are presented, with incidence rates, 1-and 5-year relative survival in 5 year intervals and multivariate HRs adjusted for covariates, each with 95% CIs. Results Lung cancer incidence increased by 64%, with an age-adjusted annual average increase of 4.9% in women and 1.4% in men in this period. Relative survival was lower in men than in women in all time periods, and men had an increased risk of dying within 5 years of diagnosis compared with women (HR 1.14, 95% CI 1.11 to 1.17), adjusted for covariates. Adenocarcinoma is now the most frequent histological group in men and women, yet the risk of dying was higher in men in all histological subtypes except squamous cell carcinoma. A higher proportion of women than men were diagnosed with localised disease, and the risk of dying was significantly higher in men among all stages, most apparent in localised disease (HR 1.25, 95% CI 1.18 to 1.33). Conclusion The findings highlight important characteristics of the lung cancer epidemic; despite a rising incidence of female lung cancer cases, women are diagnosed with less advanced disease than men; when adjusted for covariates, men have an increased risk of excess death at 5 years compared with women, irrespective of stage, age, period of diagnosis and selected histological subgroups.

Survival After Surgical Resection for Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease

“…Several studies have indicated better survival in females with NSCLC than males [4,65,66]. Explanations to this difference has been thought to result from diverging clinicophatological characteristics and altered susceptibility to environmental exposures between men and women.…”

“…Norwegian studies have suggested females to have better prognosis than males following lung cancer treatment [4,78]. A retrospective study from Haukeland University Hospital in Bergen (Norway) in which the analysis were based on 351 patients (32% females), relative 5-years survival in patients operated for non-small cell lung cancer was 66.1% for females and 45.7% for males.…”

“…These features may have caused less reliable results than findings from our cohort. Another, population-based Norwegian registry study also reported beneficial survival among females [4]. However, the study failed to adjust for comorbidities, smoking and treatment modalities including surgical resection, stereotactic body radiotherapy [SBRT] and chemotherapy.…”

“…While lung cancer incidence is levelling off in males, it is still increasing in females [3]. There are data suggesting that genders differ in terms of onset and symptoms, smoking habits, histology and survival [4].Surgical resection is the recommended treatment for localized lung cancer [5].…”

Numbers of New Cases and Trends of Cancer 1993-2012: Srinagarind Hospital Based Population, Khon Kaen, North-East Thailand

“…Anti-smoking campaigns are strongly promoted in Thailand; however, fewer females than males seem to be responding (Sagerup et al, 2011) and the numbers of new lung cancer cases in females is still gradually rising. In the last 10 years, the number of breast cancer cases in females has noticeably increased.…”