November 1, 2005
Lung cancer survival better in women
Women with lung cancer are living longer than men, even when the disease is untreated. A new study presented at CHEST 2005, the 71st annual international scientific assembly of the American College of Chest Physicians (ACCP), found that in patients receiving treatment for lung cancer, women had significantly better survival rates than men. However, in untreated patients, women also had a 21 percent decreased risk of death as compared with men, leading researchers to believe lung cancer in women has a different biologic behavior and natural history than in men.
"In patients with lung cancer receiving treatment, women have shown a better response to therapy, resulting in better survival rates," said Juan Wisnivesky, MD, MPH, FCCP, Mount Sinai School of Medicine, New York, NY. "Yet, new data suggest that even in untreated patients, women with lung cancer still live longer than men, despite the presence of other medical conditions or gender differences in life expectancy. This suggests that the progression of lung cancer has a biological basis, with the disease being more aggressive in men than women."Researchers from Mount Sinai School of Medicine reviewed 18,967 cases of stage I and II non-small cell lung cancer diagnosed between 1991 and 1999 from the Surveillance, Epidemiology, and End Results registry linked to Medicare records. Patients were grouped into three categories according to treatment received: surgery, radiation or chemotherapy, and untreated cases. After adjusting for comorbidities and general life expectancy, researchers found that women in the three groups had significantly better cancer specific, overall, and relative survival than men. In treated patients, lung cancer specific 5-year survival for women was 54 percent compared with 40 percent for men and women had a 30 percent decreased risk of death compared with men. Among untreated patients, women had a 21 percent decreased risk of lung cancer deaths after adjusting for differences in age, race, socioeconomic status, access to care, and cancer histology. Researchers also found that women lived longer than men after controlling for age, race, disease stage at diagnosis, histology, median income, geographic area, access to care, and type of treatment.
"It is clear that gender plays a role in the survival rate of men and women," said W. Michael Alberts, MD, FCCP, President of the American College of Chest Physicians. "Physicians caring for patients with lung cancer should consider the inherent progression of lung cancer among men and women when deciding on a patient's course of treatment."
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