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Lung cancer deaths are on the rise among young and middle-aged white women, mainly in the South and the Midwest, according to a study published in the Journal of Clinical Oncology.

Lung cancer remains the leading cause of cancer death among both men and women in the United States. Each year, roughly 88,000 men and 73,000 women die of the disease. For a while, lung cancer death rates were on the decline; however, some data shows that these declines have slowed in U.S. women born after 1950.

To assess regional differences among lung cancer death rates, researchers used data from the Surveillance, Epidemiology, and End Results (SEER) mortality database to examine female age-specific lung cancer death rates between 1973 and 2007. Using age-period-cohort models, they evaluated mortality trends by year of death and year of birth and closely examined patterns in lung cancer death rates among white women in 23 states. What they found were fluctuations by age and region.

Age-specific lung cancer death rates declined continuously in white women in California, but the rates declined less quickly or even increased in the remaining states among women younger than age 50 years and women born after the 1950s, especially in several southern and midwestern states. In fact, the researchers divided states into three categories: those with a favorable trend in death rates, those with an intermediate trend, and those with an unfavorable trend. California had a favorable trend; New York had an intermediate trend; and Alabama and other southern states had unfavorable trends. Alabama had a notably unfavorable trend—lung cancer death rates among women born in the 1960s were nearly double those of women born in the 1930s.

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The discrepancy in death rates among regions could be the result of public policy, tobacco control efforts, and anti-tobacco education. Although lung cancer can develop in non-smokers, roughly 80 percent of lung cancer deaths in women are due to smoking.

The researchers suggest that the unfavorable trend in younger, white women in southern and Midwestern states points to the need for additional smoking cessation interventions.


Jemal A, Ma J, Rosenberg PS, et al. Increasing lung cancer death rates among young women in southern and midwestern states. Journal of Clinical Oncology. Published early online: June 25, 2012. doi: 10.1200/JCO.2012.42.6098

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