Lung cancer has, or will shortly, become the leading
site-specific
cause of cancer deaths among women in California, Florida,
Louisiana,
Mississippi, Oregon, Texas, and Washington, (1). It is now the
leading cause of cancer deaths among women in Kentucky (2), where
the
age-adjusted rate doubled from 1971 to 1981. In Tennessee,
analysis
of cancer deaths among women by primary site revealed that, from
1968
through 1982, the lung cancer death rate increased 152.6%, from 9.7
deaths per 100,000 females in 1968 to 24.5/100,000 in 1982.
By contrast, rates for digestive system cancer have remained
relatively stable, ranging from 35.4/100,000 in 1973 to
40.8/100,000
in 1979. The 1982 rate was only 1.5% greater than the 1968 rate;
this
statistic includes all digestive cancers, whereas lung cancer rates
are site-specific. Breast cancer mortality rates rose from
21.9/100,000 in 1968 to 27.7/100,000 in 1982, a 26.5% increase.
Breast cancer death rates have fluctuated around a mean of
25.3/100,000, compared to the nearly linear rise in the lung cancer
death rate for women. Genital cancer rates in Tennessee women have
declined 29.2%, from 26.4/100,000 in 1968 to 18.7/100,000 in 1982.
The rising trend for deaths from lung cancer among Tennessee
women
parallels the U.S. trends (3). However, while U.S. rates increased
127.0% from 1968 to 1980, the last year for which final statistics
are
available, Tennessee rates rose 140.2% during that period (Figure
3).
Breast cancer mortality rates for the United States and Tennessee
rose
similarly for the same time period, showing 8.5% and 8.7%
increases,
respectively.
Higher respiratory cancer death rates for every age group are
seen
in 1982 than in 1968 or 1975 (Figure 4). Death rates in 1982 for
women aged 45-54 years and 55-64 years were 182.0% and 168.8%
higher,
respectively, than comparable 1968 rates.
Death rates for respiratory cancer among men in Tennessee rose
from 53.5/100,000 in 1968 to 90.2/100,000 in 1982, a 68.6%
increase.
The health profession and public should focus attention, time, and
effort on reducing smoking to control this new epidemic (4).
Reported by J Harris, MD, Northern Telecom, Nashville, Center for
Health Statistics, Tennessee Dept of Health and Environment.
Editorial Note
Editorial Note: Epidemics of chronic diseases do not receive the
same
public attention as epidemics of acute diseases, because they
usually
occur after a long latent period and over a longer period of time.
The steady increase of lung cancer among women in the United States
is
an example of this phenomenon. While the prevalence of smoking has
fallen substantially among men, it has not among women. Several
states have reported that lung cancer has overtaken breast cancer
as
the leading cause of cancer mortality among women. It is
anticipated
that this will soon be true for the nation as a whole.
Approximately 85% of all lung cancer cases are attributed to
cigarette smoking (5). The lung cancer epidemic is especially
tragic
because it is preventable.
References
Starzyk P. Lung cancer deaths: equality by 2000? (Letter). N
Engl J Med 1983;308:1289-90.
Division of Epidemiology, Kentucky Department of Health
Services.
The rising epidemic of lung cancer among Kentucky women.
Kentucky
epidemiologic notes and reports 1983;1811:1-2.
National Center for Health Statistics. Advance report of final
mortality statistics, 1980. Monthly vital statistics report
1983:32(Suppl).
Stolley, PD. Lung cancer in women--five years later, situation
worse. N Engl J Med 1983;309:428-9.
Office on Smoking and Health. The health consequences of
smoking,
cancer: a report of the Surgeon General. Rockville, Maryland:
Public Health Service, Department of Health and Human Services,
1982.
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