Lung cancer is the second most common cancer in men and women. However, slightly more men than women are diagnosed with lung cancer each year, and men have a greater risk (1 in 15 chance) of developing lung cancer in their lifetime than women (1 in 17 chance). The American Cancer Society estimates that there will be about 130,000 deaths from lung cancer in the United States in 2022. Of those, an estimated 68,820 people — just over 50 percent — will be male.

Although the incidence rates of lung cancer have decreased since the mid-2000s, there are notable sex-related differences in lung cancer prevalence, deaths, and survival rates.

Sex-Related Differences in Lung Cancer

The differences in lung cancer prevalence between men and women may be related to sex differences in smoking history and occupation.

Smoking History

Cigarette smoking is the leading risk factor for lung cancer, increasing the risk of lung cancer development and death by 15 to 30 times. On average, men use more tobacco products (such as chewing tobacco, cigars, and pipes) and smoke cigarettes more frequently than women do — worldwide, about 35 percent of men smoke compared to 6 percent of women.

Men tend to smoke cigarettes at an earlier age, too. One study compared smoking prevalence in teenagers between the ages of 13 and 15 across 61 countries. Researchers found that teenage boys were nearly twice as likely to smoke cigarettes than teenage girls.

Occupation

Some studies have found that certain types of occupations may increase the risk of exposure to carcinogens (cancer-causing agents) and may contribute to the development of lung cancer. These occupations — such as mining, painting, plumbing, welding, and construction, as well as jobs in iron, steel, and rubber factories — are typically male-dominated. Between 13 percent and 29 percent of lung cancer cases in men have been linked to exposure to carcinogens including asbestos, arsenic, cadmium, chromium, tar and soot, nickel, and many more. Exposure to these carcinogens can lead to lung cancer in people who have never smoked, and the risk increases in people who smoke currently or have a history of smoking.

Common Lung Cancers in Men vs. Women

Men are less likely to develop small cell lung cancers (SCLCs) but are more likely to develop a non-small cell lung cancer (NSCLC) called squamous cell carcinoma. This type of lung cancer is linked to cigarette smoking. Men who smoke more than 30 cigarettes daily increase their risk of SCLC more than 100 times.

Women develop adenocarcinoma at higher rates, and adenocarcinomas are typically diagnosed at earlier stages and earlier in life. Adenocarcinoma is the most common type of lung cancer in women and people who have never smoked.

Racial Disparities in Lung Cancer

There are racial disparities in lung cancer among Black and white men and women. Black men are almost 15 percent more likely than white men to develop lung cancer. However, Black men are less likely to develop SCLC than white men. In contrast, Black women are 14 percent less likely to develop lung cancer than white women.

Response to Treatment and Survival Rate

Responses to treatments and survival rates depend on many factors, such as the type of lung cancer and the stage of diagnosis.

Many studies have found that women tend to respond better to therapy than men, regardless of the type of lung cancer, stage of disease, or smoking history. In one study, female participants with stage 3B or stage 4 lung cancer undergoing platinum-based chemotherapy had about a 1.9-month greater survival rate than their male counterparts.

Researchers have also found sex-based differences in the five-year survival rates of lung cancer. In all types of lung cancer, men have a 17 percent survival rate, whereas women have a 24 percent survival rate.

Have Trends Changed Over Time?

Historically, men were more likely to develop lung cancer. However, trends have since changed in the United States and some European countries. The incidence rate (rate of new cases) of lung cancer among men has decreased since the 1990s. This change may be due to the initiation of smoking cessation programs and medical advances in diagnosis and treatment.

In the last five years, incidence rates have decreased by about 9.2 percent for men. In contrast, the rate has increased by 6 percent among women. Additionally, death rates for lung cancer (both SCLC and NSCLC) continue to decrease by nearly 5 percent each year for men.

There is a rising trend of lung cancer cases among women and people who have never smoked. Emerging evidence suggests that women are more susceptible to the carcinogenic effects of tobacco smoke than men are. This greater susceptibility may be due to specific genetic or biological factors. However, the underlying cause remains unknown. Carcinogen exposure within certain occupations that may be traditionally more women-dominated — such as hair styling, nail salon work, housecleaning, laundry or dry cleaning, and cooking — may also contribute to the increase of lung cancer cases among women.

Lung Cancer Symptoms in Men

Men and women experience similar symptoms in the same types of lung cancer. However, more men develop squamous cell lung cancer, which develops inside the airways in the lungs. Although similar symptoms also occur in other types of lung cancers, squamous cell lung cancer symptoms often develop before the tumor has spread to other parts of the body (metastasized).

Common symptoms can include:

• Coughing
• Difficulty breathing
• Persistent chest pain
• Wheezing
• Recurring pneumonia or bronchitis
• Coughing up bloody mucus
• Hoarseness
• Swelling of the face and neck
• Pain and weakness in the shoulder, arm, or hand
• Fever
• Fatigue
• Loss of appetite
• Weight loss

Lung Cancer Prevention and Screening

There are many ways to decrease the risk of lung cancer:

• Do not smoke, or quit smoking.
• Avoid secondhand smoke exposure.
• Check the radon levels in your home.
• Avoid exposure to known carcinogens at work when you can.
• Eat a well balanced, healthy diet.
• Exercise regularly.

Lung cancer screening is recommended for adults ages 50 to 80 who have a history of smoking more than a pack a day for the last 20 years and currently smoke or have stopped smoking within the past 15 years.

Get Support From Others Who Understand

Talking to other people who understand what you are going through can be a great source of emotional support. MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 5,100 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

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