Lung Cancer in Women: Present and Future Trends

Our plain-English summary of Lung Cancer in Women: Present and Future Trends, by E.L. Wynder, L.S. Covey, K. Mabuchi (1973).

The study

• Authors: E.L. Wynder, L.S. Covey, K. Mabuchi
• Published: Journal of the National Cancer Institute, Volume 51 No2. August 1973
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1973 paper combined a literature review, a case-control study and a comparison of men's and women's smoking habits. It does not discuss asbestos. Women with lung cancer were interviewed in 1970-72 at hospitals in New York City, Los Angeles and Houston. Analysis used 108 cases with confirmed tissue diagnoses, each matched to four female hospital controls. Smoking was closely associated with epidermoid and oat-cell cancers, less strongly with glandular types. Risk rose with cigarettes smoked daily. Among women smoking 21 or more cigarettes a day, longer smoking, earlier starting age and nonfilter cigarettes were significantly linked to higher morbidity ratios in both tissue-type groups. In these women, the link for inhalation was significant only in the combined epidermoid-and-anaplastic group. Among 1839 male and 2211 female controls, men smoked more heavily, but the differences shrank at younger ages. The authors concluded that lung cancer deaths in women would keep rising as women adopted men's smoking habits. They did not expect rates to reach those of men then of lung-cancer age, because young women began with lower-tar (filter) cigarettes than those men had.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case-control study of female lung cancer patients and hospital controls, plus a comparison of smoking habits of male and female hospital controls and a literature review
• Who was studied: Women with lung cancer interviewed February 1970 to July 1972 at hospitals in New York City, Los Angeles and Houston. Of 116 women interviewed, 108 with confirmed histologic diagnoses were analyzed (64 Kreyberg I, 44 Kreyberg II). Each case had four female hospital controls without tobacco-related diseases, matched for age, race and hospital. A separate comparison used 1839 male and 2211 female hospital controls.
• Exposure: Cigarette smoking: number of cigarettes per day, duration, starting age, long-term filter use, degree of inhalation and length of cigarettes smoked. No asbestos or other specific occupational exposure was studied.
• Main results:
  • In the 108 female cases, cigarette smoking was closely associated with epidermoid and oat-cell lung cancers, and less strongly with glandular types.
  • 8% of the Kreyberg I (epidermoid and anaplastic) patients were nonsmokers. Of the 44 Kreyberg II patients, 32 had smoked.
  • Morbidity ratios rose with the number of cigarettes smoked per day, which the authors described as a dose-response relationship.
  • Among women who smoked 21 or more cigarettes a day, three factors were associated with significantly greater morbidity ratios in both histologic groups: smoking 41 years or more, starting younger, and smoking nonfilter cigarettes.
  • Among women who smoked 21 or more cigarettes a day, those who inhaled had a significantly greater morbidity ratio than those who did not inhale. This was reported only for the combined Kreyberg I group (epidermoid and anaplastic cases together).
  • Among controls, the male-to-female ratio of ever-smokers declined from 2.3:1 in the oldest age group (65-79) to 1.3:1 in the youngest (20-34).
  • Female controls used filter cigarettes more than male controls in all age groups.
• The authors' conclusion: The authors concluded that as women adopt smoking habits similar to men's, lung cancer death rates in women will continue to increase. They did not expect those rates to reach the levels then seen in men, because young women began smoking cigarettes with lower tar yield (filters) than the men then of lung-cancer age had.
• Limitations the authors state:
  • For smokers of 1-20 cigarettes per day, differences in the smoking-intensity factors were not statistically significant, mostly because of small numbers in each subcategory.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Case-Control Study, Habit.

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