Several epidemiological studies indicate that for a given number of cigarette smoked, females may be at higher risk of lung cancer compared with males. Females who smoke appear to be at higher risk of developing small cell lung cancer than squamous cell lung cancer, whereas men who smoke have a similar risk for the two histologic conditions.Molecular epidemiological studies have also indicated gender differences in the genetic and biochemical alterations in lung cancer. Higher levels of polycyclic aromatic hydrocarbon-DNA adducts were observed in female lung cancer patients compared with males, even though the level of tobacco carcinogens was lower among the females than among the males. A higher frequency of G to T transversion mutations in the p53 gene has been observed in females compared with males. Gender differences have been identified in the expression of cytochrome P4501 A1 gene or gastrin-releasing peptide receptor gene, with females exhibiting higher gene expression.Thus, the risk for lung cancer is consistently higher in females than in males at every level of exposure to cigarette smoking; odds ratios for an sociation of lung cancer with smoking are 1.4-fold to 1.9-fold higher for females than for males, depending on the histologic type of lung cancer.Whether lung cancer represents a different disease in women than in men is unclear. If the hypothesis regarding gender differences in genetic susceptibility to lung cancer proves to be true, education for reducing passive and active exposure to cigarette smoke must have a high priority for female\u27s health
