Lung Cancer in Women: The Differences in Epidemiology, Biology and Treatment Outcomes

Maria Patricia Rivera

Expert Rev Resp Med. 2009;3(6):627-634.

Biological Differences

Lung cancer risks may be related to the balance between metabolic activation and metabolic detoxification of carcinogens, as well as the ability to repair DNA.^[33] Cytochrome P450 enzymes (CYP1A1, CYP1A2 and CYP3A4) activate tobacco-related carcinogens to highly reactive epoxides that are not detoxified, and thus can bind to DNA and result in increased DNA adducts in the lung.^[34] Mollerup et al. evaluated normal lung tissue from 159 patients with lung cancer and reported that both female and male smokers had higher levels of DNA adducts when compared with nonsmokers.^[19] Despite the fact that women in this study had fewer pack-years of smoking (22.9 vs 33.0) and were younger (56.2 vs 62.2 years of age), female smokers with lung cancer were found to have significantly higher levels of DNA adducts (25.39 vs 12.08 per 10⁸ DNA bases) compared with male patients with lung cancer.^[19] Furthermore, the increases in DNA adduct levels correlated with CYP1A1 levels.

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