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Abstract
Purpose
Female lung cancers have different clinical features and therapeutic results as compared to those of male lung cancers. The aim of this study was to analyze the differences of Korean men and women with lung cancer.
Materials and Methods
We re-analyzed the results of a national survey of lung cancer conducted by the Korean Association for the Study of Lung Cancer in 2005.
Results
Of the 8,788 patients, 2,124 (24.2%) were female. The mean age at the diagnosis was 62.5 years for the females and 64.8 years for the males and the difference was significant (p＜0.001). An age ＜50 years was more frequent for the women than for the men (16.2% vs. 7.9%, respectively; p=0.001). The stages between genders were different for the patients with non-small cell carcinoma (NSCLC) (p＜0.001), but not for the patients with small cell carcinoma. The overall survival time was longer for woman than that for the man (p＜0.001). However, the male patients had longer survival for the smokers with adenocarcinoma and the smokers with squamous cell carcinoma. The never smoker female patients had a better survival time than did the smoking female patients, but the male patient’ survival was not influenced by the smoking status. The stage-specific survival rates were better for the women at all stages of NSCLC (p＜0.001). The women who received chemotherapy had a longer survival time did the men who received chemotherapy (p＜0.001).
Conclusion
Women with lung cancer were relatively overrepresented among the younger patients and they smoked less intensively, raising the question of gender-specific differences in the carcinogenesis of lung cancer. Over-representation of adenocarcinoma was observed in the women regardless of their smoking status. Women with lung cancer had a better prognosis than men; however, the smoking females showed the worst prognosis. Gender and the smoking status are clearly important factors in the therapeutic approach to lung cancer.
References
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Figures and Tables
Fig. 1.
Proportion (%) of the pathologic types for the never smokers’ lung cancer. ADC: adenocarcinoma, BAC: brochio-loadenocarcinoma, NSCLC: non-small cell carcinoma, SQCC: squamous cell carcinoma, SCLC: small cell carcinoma.
Fig. 2.
Proportion (%) of the pathologic types for the smokers’ lung cancer. ADC: adenocarcinoma, BAC: brochioloadeno-carcinoma, NSCLC: non-small cell carcinoma, SQCC: squamous cell carcinoma, SCLC: small cell carcinoma.
Fig. 3.
Kaplan-Meier curves of the overall survival of patients according to smoking and gender. The never smoker female patients had the best survival time. The male patients’ survival was not influenced by the smoking status. MST: median survival time.
Fig. 4.
Kaplan-Meier curves for the overall survival of patients with adenocarcinoma. (A) The female patients showed superior survival compared to that of the male patients, and (B) the non-smoker patients showed superior survival compared to that of the smoker patients. MST: median survival time.
Fig. 5.
Kaplan-Meier curves of overall survival for the patients with squamous cell carcinoma. (A) The male patients showed superior survival compared to that of the non-smoking patients, and (B) the smoking patients showed the superior survival compared to that of the non-smoking patients. MST: median survival time.
Table 1.
Characteristics of Patients by Gender
Table 2.
The Prevalence of Lung Cancer according to the Age
| Age | Female, No. (%) | Male, No. (%) | p-value |
|---|---|---|---|
| ＜30 | 15 (0.7) | 27 (0.4) | |
| 30∼39 | 75 (3.5) | 74 (1.1) | |
| 40∼49 | 254 (12.0) | 424 (6.4) | 0.001* |
| 50∼59 | 434 (20.4) | 1,198 (18.0) | |
| 60∼69 | 677 (31.9) | 2,727 (40.9) | |
| ≥70 | 669 (31.5) | 2,214 (33.2) | |
| Total | 2,124 (100.0) | 6,664 (100.0) |
Table 3.
Prevalence (%) of Adenocarcinoma Compared with Non-Adenocarcinoma according to the Age
Table 4.
Univariated Survival Analysis according to Gender
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