Lung cancer is the No. 1 cancer-related killer in the United States. And while men are more likely to die from lung cancer than women, the trend is starting to change.

"If you add up the number of people in the United States who die of breast cancer, prostate cancer, colon cancer and pancreatic cancer, the number of people who die of lung cancer is greater than all of those combined," says Gregory Kalemkerian, M.D., co-director of thoracic oncology at the University of Michigan Comprehensive Cancer Center. "Almost twice as many American women die from lung cancer every year than from breast cancer. I think that statistic says it all: Women are at high risk for developing lung cancer, particularly those women who smoke, and there is a greater risk of dying from lung cancer than from breast cancer," Kalemkerian adds. In the 1970s, about 3.5 men were diagnosed with lung cancer for every woman with lung cancer. By 2000, that ratio was down to 1.5 men for every woman. Lung cancer rates in men started dropping in the 1980s, suggesting the anti-smoking message was getting through. Meanwhile, lung cancer rates kept rising in women as more women began to take up smoking. In addition, some studies suggest women may have an increased susceptibility to tobacco carcinogens, the cancer-causing agents in tobacco. Women may also be getting lung cancer at an earlier age than men. Relative to the number of diagnoses, the death rate from lung cancer is greater in men than women. "Women with lung cancer, even when you adjust for the lower incidence, do somewhat better than men do with lung cancer. That's true for many different types of cancer. We don't know why that is. It could be a hormonal effect that's somewhat protective for women or a hormonal effect in men that's somewhat more detrimental," says Kalemkerian, professor of internal medicine at the U-M Medical School. About 85 percent of those diagnosed with lung cancer will end up dying from the disease. Each year, 175,000 Americans will be diagnosed with lung cancer and 160,000 die. Worldwide, more than 1.2 million people die of lung cancer every year. The lesson: Stop smoking Any time you look at the risks in lung cancer, it's dominated by smoking: 90 percent of people who get lung cancer are smokers or former smokers. "It is clear nowadays that smoking cigarettes causes lung cancer, as well as a host of other medical problems - some of which are even bigger risks to one's health, such as heart disease. There is no question that people should not smoke. If one is smoking, then the best thing to do is quit," Kalemkerian says. Researchers at U-M are looking at the cause of lung cancer and how smoking leads to it. Other studies are focusing on how to overcome nicotine addiction in both men and women. "We aren't going to be able to affect the number of deaths from lung cancer until we really affect the cause, and the cause is overwhelmingly tobacco," Kalemkerian says. Symptoms of lung cancer Lung cancer may grow for awhile without causing symptoms. Symptoms may include: -- Cough, coughing up blood, shortness of breath, wheezing, hoarseness -- Chest pain -- Repeated chest infections, fluid around the lung -- Swelling in the neck or face -- Tiredness, weakness, loss of weight Preventing lung cancer -- Do not smoke. -- Avoid second-hand smoke. -- If you smoke, QUIT! You will start reducing your risk of lung cancer right away. -- Avoid environmental hazards such as radon, asbestos and air pollution. University of Michigan Health System 2901 Hubbard St., Ste. 2400 Ann Arbor, MI 48109-2435 United States

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