New study: Lung cancer rates rising faster in younger women. What should you know?

November 20, 2023 Swedish Cancer Team

[4 min read]

In this article: 

  • A recent American Cancer Society study found that women between the ages of 35 and 45 are being diagnosed with lung cancer at higher rates than men of the same age group. 
  • While lung cancer rates are dropping, it remains the leading cause of cancer death in the United States. 
  • Swedish cancer experts weigh in on the study, emphasizing that quitting smoking is the best way to mitigate your risk for lung cancer. 

Though lung cancer remains the nation’s leading cause of cancer death, new cases of lung cancer have been dropping consistently in the United States. While the overall rates continue to decline, American Cancer Society (ACS) researchers recently reported a disturbing trend in lung cancer rates: Women between the ages of 35 and 54 are being diagnosed with lung cancer at higher rates than their male counterparts. The ACS estimates about 238,340 new cases of lung cancer in 2023, with 117,550 cases in men and 120,790 in women. Additionally, the ACS estimates about 127,070 deaths from lung cancer in 2023: 67,160 in men and 59,910 in women. While the gender the disparity is a small one, it is an addition to the growing body of evidence pointing to the greater risks of lung cancer among women. To help us understand a little more about these findings and how we can protect ourselves, we spoke to two experts from the Swedish Cancer Institute, Thoracic Surgeon Peter White, M.D., and Nurse Practitioner Emily Grob, DNP, ARNP, who specializes in tobacco-related diseases and lung cancer screening.

Q: I’m a woman in my mid-30s. Should I be worried?

Dr. White: The short answer is no. While this study brings to light a new potential avenue for research to better understand why women ages 35-54 may be diagnosed with lung cancer at a higher rate than a comparable male group, the overall difference between those groups is exceptionally small. There are only 1 or 2 more cases in women for every 100,000 individuals. We do not know why this disparity is occurring and until we have a better understanding, it is impossible to make any type of recommendations. Another recent study found an increased prevalence of several cancers in people under 50.

"The best way to mitigate lung cancer risk is to quit smoking. Although any smoking history will increase risk, quitting smoking reduces that risk significantly, by almost 40% after 5 years. Smoking cessation has also been shown to reduce risk for other cancers, including cancers of the stomach, pancreas, liver, cervix, colon/rectum and even acute myeloid leukemia."

Q: What accounts for these jumps?

Dr. White: The cause for the increase in cancer among younger adults is not well understood, and the overall absolute numbers of cases continue to remain quite low. Until this is more thoroughly studied, we cannot make specific causal relationships or recommendations.

Q: Are screening recommendations likely to change?

Dr. White: This study is not enough evidence to adjust current screening recommendations. These were just updated in 2021 by the U.S. Preventive Services Task Force to include anyone ages 50-80 who smoked at least 1 pack of cigarettes a day for 20 years or more, is a current smoker, or has quit in the last 15 years. While there is some evidence of increased cancer rates in the younger population, smoking continues to be the number one risk factor for lung cancer.

Q: How does gender influence the likelihood of screenings?

Emily Grob: Nationally a very low percentage of eligible individuals undergo lung cancer screening. Women have historically been underrepresented in lung cancer screening research. Women continue to represent a lower percentage of eligible individuals undergoing lung cancer screening. Additional factors, such as stigma regarding lung cancer screening, influences the percentage of eligible women who undergo lung cancer screening. A lower pack-a-year history still carries risk of lung cancer, and non-eligible women are not always aware they should screen - if you have a 20-pack year history or greater you should screen.

Q: What advice do you have to mitigate risk?

Dr. White: The best way to mitigate lung cancer risk is to quit smoking. Although any smoking history will increase risk, quitting smoking reduces that risk significantly, by almost 40% after 5 years. Smoking cessation has also been shown to reduce risk for other cancers, including cancers of the stomach, pancreas, liver, cervix, colon/rectum and even acute myeloid leukemia.

Emily Grob: Other risk factors for lung cancer include secondhand smoke exposure, radon, asbestos and air pollution. If your home has never been tested for radon it is recommended that you buy a radon test kit.  

Q: Research has shown that women are slower to quit smoking. Why is this?

Emily Grob: Quitting is a journey and looks different for everyone, but factors which can negatively impact success include lack of supportive partners or community, lack of strategies to manage cravings and triggers to smoke, and concerns about weight gain. Women have historically been disproportionately impacted by tobacco marketing. 

Q: If I am in a higher-risk group, what symptoms should I be concerned about?

Dr. White: Most individuals who are diagnosed with lung cancer do not have specific symptoms, and their cancer is identified incidentally: an imaging study of the chest is performed for a different reason like pneumonia, an injury, or a low-dose lung cancer screening CT scan identifies a mass in the lung. If symptoms did occur, these could include persistent chest wall pain, wheezing feeling short of breath, coughing up blood, fatigue and unexplained weight loss. The symptoms are not very specific for lung cancer — they can occur for many other reasons. This lack of clear presenting symptoms exemplifies the need for lung cancer screening. Multiple studies have shown that lung cancer screening in the appropriate patient population reduces lung cancer death by 20% to 26%. Unfortunately, Washington State only ranks as average in lung cancer screening rates, with only 6.2% of eligible high risk individuals getting lung cancer screening CT scans. The national average is only 5.8%. [CTs are] probably the number one most impactful way to identify early-stage lung cancer and improve lung cancer survival. This continues to be one of our highest priorities for Swedish’s Comprehensive Thoracic Oncology team. Although this [ACS] study does have interest from a research perspective, the best thing for individuals to understand is whether they may be in a high-risk group and be a candidate for lung cancer screening CT scans.

Do you have some advice for those struggling to quit smoking?

Emily Grob: Planning is the first step in setting yourself up for success. Focus on your reasons to quit — write your motivation down! Start planning how you will manage triggers and cravings to smoke. Plan out a list of activities that you enjoy and help you relax. The more tools you have in your toolbox, the better. Medications, including nicotine replacement therapy, can make it easier to quit. Let the people in your life know of your plan to quit smoking. Don’t give up. Most people who quit didn't get there the first time. It’s never too late to start this journey.

Additional resources

Watch video: An interview with Dr. Sid Devarakonda, Director of Thoracic Medical Oncology at the Swedish Cancer Institute| KING 5's New Day NW

Nonsmokers and lung cancer: What to know| The Seattle Times

A recent study found rising cancer rates among younger adults. What to know.

SCI Spotlight: Dr. Jed Gorden, Director of Swedish Interventional Pulmonology and Medical Director for The Center of Lung Research

Lung Cancer Awareness

Learn more and find a provider

Our lung cancer experts at the Swedish Cancer Institute can work with you to find the right diagnostics and treatments. We don't just treat your lung cancer, we treat you. To speak with someone or make an appointment, call 1-855-XCANCER.

Do you or a family member need help quitting tobacco use? If you’re thinking about quitting, or your doctor has advised you to quit, Swedish can help. You can also learn more about developing a plan and finding support to quit at the Washington State Quitline. 

Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a provider, you can use our provider directory.

Join our Patient and Family Advisory Council.

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

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About the Author

The Swedish Cancer Team is committed to bringing you the most up-to-date insights about treatments, prevention, care and support available. We know cancer diagnoses strain you both mentally and physically, and we hope to provide a small piece of hope to you or your loved ones who are fighting the cancer battle with useful and clinically-backed advice.

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