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Gender Issues in Lung Cancer. Silvia Novello University of Turin-Italy silvia.novello@unito.it www.womenagainstlungcancer.eu. NO specific (“gender driven ”) diagnostic approach is nowadays available. NO specific (“gender driven”) therapeutic approach is nowadays available.
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Gender Issues in Lung Cancer Silvia Novello UniversityofTurin-Italy silvia.novello@unito.it www.womenagainstlungcancer.eu
NO specific (“gender driven”) diagnosticapproachisnowadaysavailable NO specific (“gender driven”) therapeutic approach is nowadays available
Deep-Sequencing Study of LungAdenocarcinoma in Female Never-Smokers “…..none of the mutations or fusion genes was found in more than one patient” Kim SC et al, PlosONE Feb 2013
Lung cancer mortality in European women: Trends and predictions Current Trends in Austria Thompson CA The Central European Journal of Medicine, 2012 Bosetti C, Malvezzi M et al Lung Cancer 2012
Cancer Mortality in Italy *leading cause forallages accounting forover 25% of all male cancerdeaths , °afterbreast and intestines§becomingsecond cause Malvezzi M et al, Tumori May 2012
US: Increasing Lung Cancer Death Rates Among Young Women in Southern and Midwestern States A: California B: New York C: Alabama Jemal A et al, JCO Aug 2012
Female Gender asindipendentPrognosticFactor in NSCLC: a Meta-analysis N trials: 39 N pts: 86800 % ♀: 37.7% Nakamura H et al, Ann Thorac Cardiovasc Surg 2011
Lung Cancer Prognosis in Spain 16.8% 28.7% Cases diagnosed with lung cancer during the period 1995-1999 were followed up until December 31, 2004 in 7 region (15% Spain population). Salmeron D et al, Respiratory Medicine (2012) 106, 1301e1308
Lung Cancer Prognosis in Spain Cases diagnosed with lung cancer during the period 1995-1999 were followed up until December 31, 2004 in 7 region (15% Spain population). Salmeron D et al, Respiratory Medicine (2012) 106, 1301e1308
Impact of Cigarette Smoking on Cancer Risk in Europe (TRC) N= 441,211 TRC=14,563 Follow-up=11yrs [AFp= populationattributablefractionusing the adjusted hazard ratios and 95% CI for current and former smokers, plus either the prevalence of smoking among cancer cases or estimates from surveys in representative samples of the population in each country] Agudo A et al, JCO Dec 2012
Women’s attitudes regarding tobacco control policies • N=5000 (2935 never smoker) • Czech Republic, France, Ireland, Italy, and Sweden • June-July 2008 • The largest proportions of women were >55 year age “New tobacco control laws would prompt smokers to quit” AGREEMENT: 46.8% Ireland 43.6% Sweden 30.5% France 20.9% Italy 15.1% Czech Republic Implementation of comprehensive smokefree laws = % people quitting smoke Dresler C et al, Scandinavian Journal of Public Health Sept 2012
Gender differences in life expectancy in Korea (’70-2005) Yang S et al; Social Science & Medicine, May 2012
Notonly Smoking • NOT evaluated • Diet • Outdoor air pollution • - OccupationalExposures • High-temperaturefrying • Pneumonia in Europe/China J Sisti, P Boffetta, Int J Cancer 2012
Radon in Never Smokers (Spain) The median concentration of radon in the males’ homes was 199 Bq/m3, vs 238 Bq/m3 in the females’ homes (Mann–Whitney U, P=.412), although there are only 11 males out of the 69 participants. A. Ruano-Ravina et al., Arch Bronconeumol. 2012
Weight for Height in Relation to Risk of Cancer in Canadian Women (N=90.000) • W/Hx was positively associated with the risk of 4 cancers (postmenopausal breast cancer, endometrial cancer, kidney cancer, and lung cancer in never smokers) Kabat GC et al, American Journal of EpidemiologyFeb 2012
Risk of lung cancer associated with domestic use of coal in China (N=37.272) Association between mean time spent indoors at home each day (excluding sleeping) and risk of death from lung cancer among users of smoky coal Compared with smokeless coal, an increased risk of lung cancer death (HR 36 in M and 99 in W) Barone-Adesi F et al, BMJ Aug 2012
RT mortality from heart disease and lung cancer after radiotherapy for breast cancer N=558 871 (45.8%b right, 46.2% left) Henson KE et al, BJC Dec 2012
Risk of a second primary lung cancer after a first invasive breast cancer according to ER status “the absolute rate of lung cancer increased with age at breast cancer diagnosis.” 12 SEER registries, 1992–2008 Schonfeld SJ et al, Cancer CausesControlAug 2012
“Ormonal Factors” and and Lung Cancer Risk: A Meta-analysis older age at menarche in North America women RR=0.83; 95%CI: 0.73-0.94 Zhang Y et al, Chin J Lung Cancer, December 2012
§ some missing data; *adjusted for area, age at study, smoking (ever/never, pack-years, time since quitting); **: adjusted for area, age at study, smoking (ever/never, pack-years, time since quitting), ETS, education, BMI. Pesatori AC et al, Int J Cancer 2012
Never Smokers: Geographic and Gender variations Sun S et al, Nat Rev Cancer 2007
Genome-wide association lung cancer susceptibility loci in never-smoking women in Asia known - 5,510 lung cancer cases - 4,544 controls new Lan Q et al, Nature Genetics Nov 2012
We fight against the stigma…… BUT we MUST eradicate the problem at its root