Current Trends Lung Cancer and Breast Cancer Trends Among
Women -- Texas
In 1982, lung cancer equaled breast cancer as the leading cause
of
cancer death among Texas women (Figure 1).* For 1970-1982, the
age-adjusted** lung cancer mortality rate per 100,000 women almost
doubled from 11.9 to 22.6, and the proportion of deaths from
malignant
neoplasms attributed to lung cancer increased from 9.7% to 17.4%.
During the same period, breast cancer mortality rates and the
proportion of total malignant neoplasm deaths attributed to breast
cancer remained stable (Table 3).
The highest age-adjusted*** lung cancer rates and those with
the
steepest increases occurred among Texas women 65 years of age and
older; the rate rose from 52.0/100,000 in 1970 to 110.1/100,000 in
1982. Because 85% of all lung cancer deaths in the United States
are
attributable to cigarette smoking, the increasing rate for older
Texas
women can be related to the increasing number of women in this age
cohort who began smoking cigarettes in the 1930s and 1940s (1).
Reported by V Guinee, MD, G Giocco, MS, MD Anderson Hospital and
Tumor
Institute, University of Texas System Cancer Center, Houston, L
Suarez, MS, WD Carroll, MPH, WE Barrington, MPH, A Menchetti, CE
Alexander, MD, State Epidemiologist, Texas Dept of Health; Div of
Surveillance, Hazard Evaluations and Field Studies, National
Institute
for Occupational Safety and Health, Div of Field Svcs, Epidemiology
Program Office, CDC.
Editorial Note
Editorial Note: Based on the historic increase in the exposure of
U.S. women to tobacco, an epidemic of lung cancer has been
predicted
(1,2). Although breast cancer remains the leading cause of cancer
death among U.S. and Canadian women, a steady rise in the long-term
secular trend of lung cancer mortality rates has been observed in
both
countries (1,3). In at least two states, the recent predominance
of
lung cancer over breast cancer has been documented through reviews
of
age-adjusted mortality rates (4,5).
In 1982, 27% of Texas women surveyed reported currently smoking
cigarettes, and 42% reported having smoked at least 100 cigarettes
at
some time (6). These data point to the continuing need for public
health intervention to reduce smoking and the burden of cancer
related
to it.
While cigarette smoking is the single most important cause of
lung
cancer, the increase over the past 50 years in the number of U.S.
women in the industrial workforce increases the likelihood of
exposure
to occupational carcinogens. Occupational agents associated with
lung
cancer include arsenic, asbestos, chloroethers, chromates, ionizing
radiation, nickel, and polynuclear aromatic hydrocarbon compounds.
The risk of lung cancer may be sharply increased as cigarette
smoking
interacts synergistically with some of these agents (e.g.,
asbestos)
(7).
References
Office on Smoking and Health. The health consequences of
smoking: cancer. A report of the Surgeon General. Rockville,
Maryland: Public Health Service, U.S. Department of Health and
Human Services, 1982.
Doll R, Peto R. The causes of cancer. Quantitative estimates
of
avoidable risks of cancer in the United States today. New
York:
Oxford University Press, 1981.
CDC. Lung cancer among women--Canada. MMWR 1984;33:67-9.
Kentucky Cabinet for Human Resources. The rising epidemic of
lung
cancer among Kentucky women. Kentucky Epidemiology Notes and
Reports 1983;18.
Starzyk PM. Lung-cancer deaths: equality by 2000? (Letter).
N
Engl J Med 1983;308:1289-90.
Texas Department of Health. Texas behavioral risk factor
survey:
an overview. 1982.
CDC. Leading work-related diseases and injuries--United
States:
occupational lung diseases. MMWR 1983;32:24-6, 32.
*Rates determined from death certification International
Classification of Diseases (ICD) categories 162 (lung cancer) and
174
(breast cancer).
**Age-adjusted by 5-year age groups using the total 1970 U.S.
population as a standard.
***Age-adjusted by 5-year age groups using the 1970 U.S. population
65
years and older as a standard.
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