New study finds that young and middle-aged women are at higher risk for lung cancer than men

By Claire Wolters | Fact-checked by Davi Sherman
Published October 16, 2023

Key Takeaways

  • Young women are at higher risk for lung cancer than young men, according to research by the American Cancer Society.

  • The research displays a change in sex-based risk levels, as young men were formerly at higher risk for lung cancer.

  • Encouraging smoking cessation efforts and supporting research into other risk factors for lung cancer could help raise awareness and reduce risks.

Young women may be at higher risk for lung cancer than young men, and risk levels can persist with age, according to a new study.

Led by researchers at the American Cancer Society, the study examined lung cancer incidence rates in 50 to 54 year olds in the United States. It followed up on data from a 2018 study, which examined individuals younger than 50. 

Changing trends

According to Ahmedin Jemal, DVM, PhD, lead author and senior vice president of Surveillance & Health Equity Science at the American Cancer Society, both the current findings and the 2018 study have important implications for lung cancer treatment and diagnosis. The 2018 study was significant in that it “reversed the historically higher incidence rates in men than women,” he says.[] The new findings also show how trends continue in slightly older populations, he adds.

The majority of lung cancer cases in the US are among people who smoke. According to the CDC, cigarette smoking is linked to 80% to 90% of lung cancer deaths in the US.[]

Despite the higher cancer incidence rates, the study does not suggest that young women smoke more often or more intensely than young men, “except for a slightly elevated prevalence among those born in the 1960s.”

Why are women at a higher risk?

With unknowns at play, Dr. Jemal says that more research is needed to investigate what is increasing lung cancer risks for young women. Potential next steps include examining “if there are any biological differences that contribute to the higher lung cancer incidence rates in young women than young men, including differences in metabolizing cigarettes, [and] if there are sex differences in environmental exposures other than cigarettes, including occupational exposures and air pollution.”

Sara Belton, PhD, RN, nurse navigator for Providence Saint John’s Health Center’s Lung Screening Program at the Cardiothoracic Outpatient Clinic in Santa Monica, CA, says the study sheds light on how there might be “differences in how lung cancer develops in women vs men on a cellular or disease process level that we have not yet discovered.”

Other risk factors

“Further research is needed to better understand the personal, social, and environmental risks linked to lung cancer, and such studies are underway in many countries,” Dr. Belton continues.

Additionally, she says, “there are numerous reasons why people develop lung cancer. While the study notes that the vast majority of cases are from cigarette smoking, there are also cases that occur in people who have never smoked.”

Other potential lung cancer risk factors, such as exposure to secondhand smoke, radon gas in the home, outdoor pollution, and genetic components of lung cancer, are under investigation, Dr. Belton says.

While keeping an eye out for confounding risk factors, the study researchers write that it remains crucial for doctors to encourage—and even intensify—smoking cessation efforts in younger and middle-aged women.

“Only about 15% of lung cancer cases occur among never-smokers,” Dr. Jemal says. So, for men and women, young and old, “to reduce the burden of lung cancer, it is important to intensify efforts to promote smoking cessation,” he adds.

Encourage your patients to quit smoking

Dr. Jemal encourages doctors to “advise their cigarette-smoking patients to quit smoking, treat them for tobacco dependence, and refer them for counseling.” Doctors should also encourage eligible patients to receive lung cancer screening, he adds.

Increasing public awareness about lung cancer risk factors may also be important in reducing incidence rates and directing people to treatment, according to Dr. Belton.

“While we have done a great job of getting the message out about women’s breast cancer risks, we have not done as good a job at communicating women’s lung cancer risks,” she says. “Better communication of the revised screening guidelines will help to spread the message, but it does take time to increase awareness and screening rates. The American Cancer Society does a great job of communicating and advocating for cancer awareness, and has good information on their website for clinicians and the public.”

New lung cancer screening guidelines, which were updated by the US Preventive Services Task Force in March 2021, call for lung cancer screenings in adults aged 50 to 80—a change from previous recommendations of ages 55 to 80.[]

What this means for you

Young women are at higher risk for lung cancer than young men, according to research by the American Cancer Society. The researchers say that more studies are needed to understand lung cancer risk factors other than smoking, but continue to stress the importance of smoking cessation in risk reduction.

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