The evolving landscape of sex-based differences in lung cancer: a distinct disease in women.
The evolving landscape of sex-based differences in lung cancer: a distinct disease in women.
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DOI：
10.1183/16000617.0100-2021
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发表时间：
2022-03-31
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与几十年前肺癌主要是男性吸烟的疾病形成鲜明对比的是，现在女性的肺癌发病率与男性相当，甚至更高，而且在世界许多地区都在以惊人的速度上升。与男性相比，女性面临着一系列独特的肺癌风险因素。这些包括外源性暴露，包括氡、先前的辐射和室内烹饪材料(如煤)产生的烟雾，以及内源性暴露，如雌激素和独特的基因多态。目前的筛查指南只涉及烟草使用，可能低估了女性患肺癌的风险。在导致制定当前筛查指南的一些里程碑式的前瞻性研究中，妇女也没有得到很好的代表。即使考虑到其他临床和人口统计特征，被诊断为肺癌的女性与男性相比，也有明显的死亡率优势。然而，全身治疗的结果和副作用可能存在性别差异，特别是化疗和免疫治疗。需要正在进行的研究来更好地调查这些差异，以解决全球肺癌人口结构的快速变化。肺癌患者的性别差异贯穿于整个护理过程。这表明肺癌可能越来越多地被视为女性的一种独特的疾病，对筛查和治疗有影响。肺癌研究应该捕捉到这些性别差异。Https://bit.ly/2WfhaB4
In stark contrast to a few decades ago when lung cancer was predominantly a disease of men who smoke, incidence rates of lung cancer in women are now comparable to or higher than those in men and are rising alarmingly in many parts of the world. Women face a unique set of risk factors for lung cancer compared to men. These include exogenous exposures including radon, prior radiation, and fumes from indoor cooking materials such as coal, in addition to endogenous exposures such as oestrogen and distinct genetic polymorphisms. Current screening guidelines only address tobacco use and likely underrepresent lung cancer risk in women. Women were also not well represented in some of the landmark prospective studies that led to the development of current screening guidelines. Women diagnosed with lung cancer have a clear mortality benefit compared to men even when other clinical and demographic characteristics are accounted for. However, there may be sex-based differences in outcomes and side effects of systemic therapy, particularly with chemotherapy and immunotherapy. Ongoing research is needed to better investigate these differences to address the rapidly changing demographics of lung cancer worldwide. Sex-based differences in lung cancer span the care continuum. This suggests lung cancer may increasingly be viewed as a distinct disease in women, with implications for screening and treatment. Lung cancer research should capture these sex-based differences. https://bit.ly/2WfhaB4
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