Lung cancer rates down, with a narrowing gender gap

Invasive lung cancer, still the leading cause of cancer deaths in the United States, claimed fewer lives over the five-year period ending in 2009, says a report issued Thursday by the Centers for Disease Control and Prevention. Driven largely by the success of anti-tobacco campaigns, the decline in lung cancer was greater in men than in women, however.

The grim result: a longstanding gender gap, in which women have lagged behind men in lung cancer rates, is narrowing.

Fifty years after the U.S. surgeon general declared tobacco a hazard to the public's health, more than a million new cases of lung cancer were diagnosed from 2005 to 2009, according to the CDC's latest accounting. More than two-thirds of those diagnoses were in men and women 65 older, and rates of lung cancer in those groups showed the most modest declines.

After the 1964 surgeon general report unambiguously identifying tobacco use as a cause of disease, the growth in the number of women taking up the habit has outpaced that of men. And women have quit at a slower rate than men. Lung cancers reflected the convergence of smoking rates in men and women across the board: There were 569,366 lung cancers diagnosed in men between 2005 and 2009, and 465,027 among women.

Among men between the ages of 35 and 64, lung cancer rates showed substantial declines and were most pronounced (down 6.5% annually during 2005-2009) among the youngest men, 35 to 44, in that group. The incidence of lung cancers declined markedly in women ages 35 to 44 and 55 to 64 (down annually 5.8% and 3.7%, respectively).

But the rate of invasive lung cancer scarcely budged among women ages 45 to 54 (down annually 0.1%). Born in the 1950s and 1960s, these women were young adults during the 1970s, when women were the targets of aggressive marketing campaigns by tobacco companies.

Overall, the Northeast saw the smallest declines in lung cancer rates. But some states -- Alabama, Mississippi and Alaska -- were notable for their lack of progress in driving down lung cancer rates.

The CDC has termed lung cancer a "winnable battle" because 80% to 90% of lung cancers can be attributed directly to tobacco use or to secondhand smoke. (Environmental exposures, including to radon and to air pollutants, also are a cause of lung cancers.) But the march toward victory has lost momentum, the health agency suggested. 

In an editorial note accompanying its report, the CDC chided states for devoting only $640 million to tobacco control efforts in 2010. That amounts to a mere 2.4% of their annual state tobacco revenues and less the one-fifth the annual budget -- $3.7 billion -- that CDC has estimated would be necessary to sustain comprehensive tobacco control programs across the states.




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