Lung cancer death rates are going up among women, and down among men. The reason has everything to do with tobacco take-up

Even though decades of public health campaigning of the risks of tobacco use are driving reductions in lung cancer from smoking, mortality from the disease among women in several European nations is likely to keep increasing for years to come. 

While lung cancer deaths among European women aged 25-44 continue to remain low, mortality is projected to keep increasing among women over 65, particularly in nations like France, Spain and Italy. 

It’s a similar story among other western nations like the UK, Australia and the US, where lung cancer is expected to remain the most lethal cancer among women into the next decade.The reason is a straightforward one: women with lung cancer are starting to reach the ages where mortality catches up.  

While some western nations saw upwards of 7 in 10 men lighting up before awareness of the deadly risk of tobacco smoke became mainstream in the latter half of the 20^th century, the peak use of cigarettes among women came decades later. 

“Women now aged 45 to 65, born in the 1960s and 1970s, have smoked less and stopped earlier than those born in the 1950s, who were in their twenties in the 1970s when smoking among young women was most prevalent,” says Professor Eva Negri from Bologna University, who co-led the research published today by the European Society for Medical Oncology. 

In Europe and Britain, one fifth of cancer-related deaths are from lung cancers. This year, lung cancer related death is expected to jump 14% in France, and around 5% in Italy and Spain in 2023.  

Within a decade, rates are expected to trend down as smokers make up less and less of the over 65 population in these countries. Australia’s figures are similar.   

Like Europe, Australia will see a spike in lung cancer mortality among women 

Last year, research showed lung cancer continues to be a top-three cause of cancer death among men and women in Australia.  

While it’s currently the most common cause of cancer death among men, it’s expected to be replaced by prostate cancer in the next two decades.  

Lung cancer is the top cancer-related killer of women in both the UK and Australia.  

And as the Australian Cancer Council’s Screening and Immunisation Committee chair and Daffodil Centre director Karen Candell explains, it’s expected to remain the top killer of women in Australia for some time. 

That’s due to a delay of up to 30 years between first tobacco exposure – such as by regular smoking – and lung cancer mortality.  

“In many countries, women took up smoking at high levels many years after men, and this was driven by cultural changes and direct targeting of women by the tobacco industry from the 1960s,” says Professor Candell. 

“In Australia, while men still bear a significantly higher tobacco-caused lung cancer disease burden because they smoked at very high rates in the 1940s and 1950s, their mortality rates are also reducing faster, as the appallingly high rates of male smoking began to fall with efforts in tobacco control.” 

The Daffodil Centre’s research suggests 400,000 new cases of lung cancer will be diagnosed among both men and women in Australia from 2020-2044, with around 235,000 deaths during the same period. Around four in five lung cancer deaths are caused by smoking. 

The good news is that education is taking effect 

Regions with aging populations like Europe, the UK, US and Australia will see the total number of cancer deaths increase in the coming years. 

High wealth nations like these typically see fewer early deaths for any reason, so their longer-lived adults instead reach ages more susceptible to cancer-related mortality.  

Overall, however, the rate of cancer death across these populations continue to fall thanks to improvements in diagnosis, treatment and preventative measures. 

And despite more female lung cancer patients now reaching those ages where mortality from the disease is expected, younger age groups are seeing markedly fewer cases and deaths thanks to long-term public education efforts. 

In Europe, as with other western nations, younger women are less likely to have lung cancer, and mortality projections are lower. Still, European researchers are encouraging their governments to be vigilant. 

“The advances in tobacco control are reflected in the favourable lung cancer trends but more could be done in this respect, particularly among women,” says Professor Carlo La Vecchia from Milan University.  

“No deaths from lung cancer have been avoided in women, both in the EU and the UK, during the period between 1989 and 2023.” 

It’s the same story down under. 

“The effects of new tobacco control programs will not have an impact on the expected lung cancer mortality rates up to 2044,” says Candell. 

“This highlights the urgent need for continue efforts on tobacco control to reduce lung cancer burden in the future, as well as the potential role of lung cancer screening, as well as lung cancer treatment improvements, to reduce lung cancer mortality in the short and intermediate term.”