Global lung cancer death rates for women to increase

2016 09 14 14 37 45 241 Cigarette Smoking 400

Global lung cancer mortality rates for women will increase by 43% from 2015 to 2030, at which point more women are projected to die from lung disease than breast cancer, according to a study published online August 1 in the American Association of Cancer Research journal Cancer Research.

Research has shown that using low-dose CT (LDCT) to screen for lung cancer reduces mortality rates by 20%, but the study findings suggest it's not being used as effectively as it could be, wrote a team led by Juan Carlos Martín-Sánchez, PhD, of the International University of Catalonia in Barcelona, Spain.

"Low-dose computer tomography implementation is still a matter of debate," the team wrote.

Lung cancer mortality has already surpassed breast cancer mortality in several countries, according to the study authors. In fact, the global age-standardized breast cancer mortality rate is projected to drop by 9% in the same time frame as lung cancer mortality rates are expected to increase.

"Previous studies have shown that breast cancer prevention and control efforts ... have resulted in clear declines in breast cancer mortality rates," they noted.

Historically, the incidence rate for lung cancer per 100,000 women has been lower than that of breast cancer -- ranging from 0.8 in Middle Africa to 33.8 in North America -- but the disease has one of the lowest five-year survival rates, at less than 20% in developed countries. And since 60% of lung cancer deaths in women are due to smoking, mortality rates vary depending on differences in tobacco use across geographic regions.

Martín-Sánchez and colleagues used data from the World Health Organization (WHO) Mortality Database for 2008 to 2014 to estimate mortality rates of lung and breast cancer in women around the world. The team grouped lung and breast cancer deaths by country, year, and patient age for 52 nations.

They compared current aged-standardized mortality rates to projected mortality rates for both diseases, finding that more women will be dying of lung disease by 2030:

Mortality rates for lung & breast cancer, 2015 vs. 2030
  2015 mortality rate per 100,00 women 2030 projected mortality rate per 100,000 women
Lung cancer 11.2 16
Breast cancer 16.1 14.7

"By 2030, the lung cancer [age-standardized mortality rate] is projected to be higher than the breast cancer [rate] in women in 26 of 52 analyzed countries," they wrote. "Twenty-four of these countries belong to the high-income group."

How might the rising lung cancer mortality rate be circumvented? In the U.S., the use of LDCT for lung cancer screening remains spotty -- despite a positive recommendation from the U.S. Preventive Services Task Force (USPSTF). Some attribute the slow uptake to low Medicare reimbursement and inadequate patient and physician awareness about the exam.

Absent progress with CT screening, efforts should focus on helping women quit smoking, Martín-Sánchez and colleagues noted.

"Lung cancer screening programs may be implemented in the near future in different countries worldwide, subsequently reducing our projected mortality rates," the group wrote. However, "prevention efforts should focus on smoking avoidance and cessation."

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