부산대학교 도서관

The incidence trend of lung cancer has significantly changed in recent decades, with a decrease in frequency among men and a rise among women. This change can mainly be attributed to altered smoking habits, characterized by an increase in nicotine consumption among women and a declining trend among men. Additional explanations for the increase in the incidence among women include an elevated susceptibility to the carcinogenic effects of both active and passive cigarette smoking as well as the effects of outdoor and indoor air pollution, radon and asbestos. These differences in sensitivity could be attributed to genetic, hormonal or metabolic factors. In the past squamous cell carcinoma was histologically dominant in men, whereas nowadays the distribution of histological subtypes is currently balanced in both sexes, with adenocarcinoma being the most frequent histological subtype. Genetic alterations, especially epidermal growth factor receptor (EGFR), Kirsten rat sarcoma virus oncogene homolog (KRAS), v‑raf murine sarcoma viral oncogene homolog B1 (BRAF) and tumor protein p53 (TP53) gene mutations, are more frequently observed in women than in men. Regarding treatment it is evident that women respond better to platinum-based chemotherapy, a combination of chemotherapy and immunotherapy and targeted therapy compared to men; however, women also experience more side effects. In contrast, women respond less favorably to monotherapy with immunotherapy. In early stages of the disease women have a more favorable prognosis after resection and irradiation than men, making the female gender an independent positive prognostic factor regardless of stage, histology and treatment form (except for monotherapy with immunotherapy). Furthermore, it could be shown that women with a history of smoking benefit more from computed tomography (CT) screening than men.