New research shows that many
women recently diagnosed with lung cancer have normal lung function and
perform better on lung function tests compared with their male
counterparts. A study published in the May issue of CHEST, the
peer-reviewed journal of the American College of Chest Physicians (ACCP),
shows a significant proportion of women with newly diagnosed lung cancer
presented with normal lung function on pulmonary function tests.
Furthermore, among patients with lung cancer, significantly more men than
women presented with COPD, a well-known independent risk factor for lung
cancer that progressively and permanently reduces lung function.
"These findings suggest that the susceptibility patterns among women
may be different compared with men," said Raghu Loganathan, MD, FCCP,
Lincoln Medical and Mental Health Center, Bronx, NY. "Using the presence of
COPD alone as a criterion to determine a patient's risk may miss women with
lung cancer."
Dr. Loganathan and colleagues from Memorial Sloan-Kettering Cancer
Center in New York used pulmonary function testing to compare the
prevalence of COPD in 151 men vs 143 women who were newly diagnosed with
lung cancer. Spirometry testing was used to determine pulmonary function.
Patients were considered to have COPD when the FEV1/FVC ratio was lower
than 70 percent; an FEV1/FVC ratio of greater than 70 was considered normal
lung function. At the time of diagnosis, 72.8 percent of men presented with
COPD compared with 52.4 percent of women. Among patients who smoked (87
percent), COPD occurred in 74.8 percent in men and 57.3 percent in women.
Overall, smoking status and older age were strongly associated with COPD.
Both former and current smokers were about 10 times more likely to have
COPD compared with nonsmokers.
"The absence of COPD should not lower the risk in a female patient who
is otherwise considered to be at increased likelihood for developing lung
cancer," said Dr. Loganathan. "Physicians must consider additional (and
well- established) risk factors, such as smoking history and age of the
patient, when contemplating lung cancer screening." The researchers also
suggest that gender-based differences in spirometry should be considered in
constructing strategies for screening for lung cancer.
Although screening for lung cancer is currently not a standard level of
care, persons considered suitable candidates for lung cancer screening
include those with heavy smoking history (> 30 pack years), age greater
than 50 years, presence of COPD, occupational exposure to asbestos, or
history of exposure to radiation. Currently, most screening programs and
clinical trials choose patients for lung cancer screening based on smoking
history and not on the presence or absence of COPD.
"Understanding the role that gender has in the development of lung
cancer may help identify more advanced screening methods and new approaches
to preventive care," said W. Michael Alberts, MD, FCCP, President of the
American College of Chest Physicians.
CHEST is a peer-reviewed journal published by the ACCP. It is available
online each month at chestjournal . The ACCP represents
16,500 members who provide clinical respiratory, sleep, critical care, and
cardiothoracic patient care in the United States and throughout the world.
The ACCP's mission is to promote the prevention and treatment of diseases
of the chest through leadership, education, research, and communication.
For more information about the ACCP, please visit the ACCP Web site at
chestnet .
American College of Chest Physicians
chestnet