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The profile of the typical lung cancer patient in Spain is changing rapidly. Traditionally associated with men who have smoked all their lives, oncologists now find in their outpatient clinics a large number of women, sometimes very young, sometimes pregnant and, among them, many who have never even lit up a cigarette. In 2023 some 28.82% of lung cancer diagnoses applied to women: 9,016 out of a total of 31,282. This is four times more than in 2006, when the subtotal for women stood at 2,038 cases (10% of the total). It is also almost twice as many as in 2017, when 5,917 were diagnosed, accounting for 20% of the total. All these statistics come from the annual reports of the Spanish society of medical oncology (SEOM). The number of female patients is growing at a rate of 10% a year, with an added concern: between 20% and 30% of those diagnosed have never smoked, double that of male non-smokers with lung cancer.
The causes of the increase in the incidence of lung cancer in women are varied. The first, however, has to do with smoking habits. "In Spain, women started smoking later on in the 1970s and we are only now seeing the consequences," explained Javier de Castro, head of the medical oncology unit at La Paz University Hospital in Madrid and a specialist in lung cancer. Besides smoking, other factors surface, such as environmental pollution, hormonal factors or a predisposition to this cancer type due to genetic factors in women. The last main cause is the accumulation of radon, a gas produced by the natural, radioactive disintegration of uranium present in certain soils and rocks, which is absorbed into the air we breathe and which, according to the World Health Organization (WHO), is already known to be the trigger of between 3 and 14% of lung cancers.
The introduction of new tobacco-related products on the market may continue to fuel the diagnosis of more lung cancers in women. While there is still a certain gap between men and women for smoking traditional tobacco (28.9% to 22.6%), in the case of electronic cigarettes and vaping the figures between both genders are very similar: 6.9% of women have used them in the last year, a percentage almost equal to that of men (7.2%), as shown by the latest 2024 'Edades' survey, a national survey on alcohol and drug use in Spain. "We even see that in the 15-20 age group, women's consumption is higher because there is no perception of risk," said De Castro, who warns of two worrying reasons why teenage girls are attracted to vaping.
"On the one hand, it is a means of achieving social vindication. On the other, we find young people who use e-cigarettes as a way of controlling their weight, following the canons that are spread on social media about a type of staying thin that is seen as healthy and beautiful, at a time in their lives when their bodies are undergoing many changes", said De Castro, reminding us that: "This concept that vaping is better than other forms of tobacco should be eradicated. Vaping also causes lung cancer and other associated pathologies and can lead to death."
According to SEOM estimates, lung cancer was already the third most diagnosed tumour in women in 2024, with 10,285 cases, behind only breast cancer (36,395) and those of the colon and rectum (17,285), having already overtaken uterine cancer. In addition, malignant tumours of the trachea, bronchioles and lungs, all related to smoking, are already the second most deadly tumours in Spain among women (5,967 deaths in 2022 being the latest figures available), with breast cancer accounting for the most deaths (6,677).
Lung cancer survival in women (18%) is much lower than that of breast cancer (86%) and its upward trend continues steadily. Therefore the experts predict that, in the coming years, as has already happened in the Nordic countries, lung cancer mortality in women will overtake that of breast cancer.
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