Lung cancer deaths among women have overtaken those from breast cancer for the first time, marking a grim medical milestone in the history of this often incurable disease.

For 20 years, breast cancer fears have been the more dominant among women, but new figures released by the Cancer Research Campaign show that lung cancer is now the bigger killer. Lung cancer claimed the lives of 12,765 women in 1999, while breast cancer killed 12,677. The dreadful legacy of smoking, which women took up later than men, is seen in the rising trend in female lung cancer deaths, up 36 per cent since 1979. Deaths from breast cancer have been falling since 1989 – helped by screening, early detection and new treatments – and are 5 per cent below the level 20 years ago. Professor Gordon McVie, the director general of the campaign, said: "Lung cancer could almost be an invisible disease for all the attention paid to it. Yet it claimed the lives of 12,700 women last year. Cigarettes are potentially death in a packet. More young girls than boys are taking up the habit and older women are not as successful as men in packing it in." The women dying from lung cancer are those who took up smoking 30 to 35 years ago, when the popularity of smoking was at its peak. Cigarettes with names like "More" and "Virginia Slims" were manufactured and sold as a long and slender version of cigarettes smoked by men. The subtext was simple – smoking helps you lose weight. Forty years later, the legacy of that advertising is a rising death toll from lung cancer among women. The proportion of women smokers is falling – in 1966, 46 per cent of women smoked – but experts predict that the death rate from lung cancer among women will continue to rise before it starts to drop. Now that everyone is more aware of the risks and wiser to the tricks of the advertising trade, tobacco companies put more importance on product placement. When Lauren Booth, the Prime Minister's sister-in-law, last week defended her right to the odd cigarette while pregnant, it made manufacturers glow. Pictures of a smouldering Liz Hurley in the current issue of GQ magazine were a marketeer's dream. Smoking has always been a mark of rebellion. Research by Amanda Amos at Edinburgh University showed that teenage girls who smoked tended to be the most popular. "They had more boyfriends, they were more socially engaged and their smoking filtered into the identity they wanted to project. Smoking is one of the most overt things a teenage girl can do. It is a very good way of projecting a popular image. Boys have sport but girls seem to have fewer ways to project a popular image," Dr Amos said. Smoking among teenage girls rose suddenly in the middle of the last decade to 32 per cent of those aged from 16 to 19 in 1996, 5 percentage points ahead of boys their age. By 1998, the figure for girls had slipped to 31 per cent but that for boys had climbed to 30 per cent. Smoking rates have oscillated in that age group for two decades, ranging from 32 per cent to 26 per cent among boys and 32 per cent to 25 per cent among girls. Boys start experimenting with cigarettes earlier than girls, but girls soon overtake them. By the age of 15 more girls smoke than boys. Lung cancer still claims the lives of many more men than women – in 1999, 20,602 men died of the disease compared with 12,765 women – but the numbers are falling. Deaths from lung cancer among men have fallen faster than for any other cancer, down 31 per cent since 1980, a reflection of the decline in smoking rather than improvements in treatment. Lung cancer is often regarded as the Cinderella of cancers. It has one of the lowest survival rates of any cancer, because it is mostly too far advanced to treat by the time it is diagnosed, and survival rates are worsening while for most cancers they are improving. Figures published last April by the Office for National Statistics showed 95 per cent of people with lung cancer diagnosed between 1991 and 1993 died within five years, 0.9 per cent more than among those diagnosed between 1986 and 1991. Among women with breast cancer, 16.3 per cent of those diagnosed from 1991 to 1993 died in five years, 6 per cent fewer than among those diagnosed from 1986 to 1991. Long waits for treatment do not help. Doctors at the Beatson oncology centre of the Western Infirmary in Glasgow, found one in five patients became incurable while waiting for radiotherapy, according to a study published in the journal Clinical Oncology in July. They said the problem was nationwide. Professor Michael Richards, the Government's adviser on cancer, admitted waiting times for treatment were "unacceptable".

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