Women are more vulnerable than men to the lung cancer

Women are more vulnerable than men to the lung cancer

Even fewer, smokers are more likely to develop the disease than their male counterparts.

Men and women are not equal to lung cancer. This is in any case what suggests a study published at the end of May in the New England Journal of Medicine. According to US researchers, the number of new cases of lung cancer has declined among men and women aged 30 to 54 in the last 20 years. But this decline, which is undeniably linked to a decrease in smoking, has been much steeper for men.

"Women will inhale more toxins than men to get the level of nicotine they need"

As a result, among Caucasian and Hispanic women born in the mid-1960s, the incidence of lung cancer now exceeds that of men. However, while the proportion of female smokers has increased significantly in the population, it has never exceeded that of smokers. "In addition, the average number of cigarettes smoked per day continues to be lower among women," note the authors of the study. The quantity of cigarettes smoked, however, does not appear to be a good criterion for comparing the risks associated with smoking. "When doing the addiction tests, like Fagerström's, women have the same level of dependence as men for a lower amount of smoked cigarettes. This means that they will inhale more toxins than men to get the level of nicotine they need, "says Dr. Ivan Berlin, pharmacologist at the hospital Pitié-Salpêtrière in Paris and Secretary General of the French Society of tobacco.

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A difference that could be explained in particular by the hormonal status of women. In fact, estrogen / progestin levels increase the metabolism of nicotine. In women of childbearing age, nicotine is eliminated faster. This effect of estrogen has been fully demonstrated in pregnant women in a study published in late 2017 in the Journal of Studies on Alcohol and Drugs. Pregnant women smoked fewer cigarettes than the control group, but had similar levels of cotinine in saliva (a marker of nicotine levels).

This more intense inhalation could explain another peculiarity of lung cancer in women: their location. "These are cancers that are often further down the lungs. Less close to the trachea than in men, "says Pr Julien Mazieres, pneumo-oncologist at the University Hospital of Toulouse. For the specialist, the lung cancer of women undoubtedly has specificities. "In addition to their localization, they are histologically different tumors (by studying the microscopic structure of tissues, NDLR) from those of men," says Pr Julien Mazières.
It remains to be explained why women seem more exposed to the risk of lung cancer. "Several studies suggest a DNA repair deficit that would make women more vulnerable to tobacco but also to other toxic substances encountered in the workplace. In addition, other studies suggest that the effects of tobacco could be potentiated by estrogen, "explains Pr. Julien Mazières.


Because as the specialist recalls, it is the tobacco that remains the worst enemy of the lungs. As for men, the occurrence of bronchopulmonary cancer in women depends primarily on the duration of smoking, the number of cigarettes smoked per day and also the age of the first cigarette. "Then only are added hypotheses that suggest that the woman is more vulnerable," continues Julien Mazières.

A vulnerability that could be an additional argument to take the plunge and quit when you are a woman. "For the main lesson of the study in the New England Journal of Medicine is: the collapse of cancer in young people, both men and women.

And should we call him back? Lung cancer is now the second most common cancer in women. However, on the front of tobacco control, the youngest women are more difficult to convince. In fact, while the number of smokers is decreasing among men aged 18-24, it remains stable among young women of the same age. They are thus 29% daily to smoke according to data published by Public Health France on the occasion of the World No Tobacco Day.