Lung cancer death

Death rates from lung cancer among white women in the United States increased by 600% between 1950 and 2000, a report from the US surgeon general stated this week. The rate was 5 per 100 000 in 1950 and 35 per 100 000 in the year 2000.

In 1950 lung cancer accounted for only 3% of all female cancer deaths, whereas in 2000 it accounted for an estimated 25%. Twenty seven thousand more women died of lung cancer than of breast cancer in 2000.

The 700 page report, which weighs 2.7 kg, updates and expands on the first report by the surgeon general, in 1980, The Health Consequences of Smoking for Women.

It is the work of nine senior federal health officials from the Centers for Disease Control and Prevention, Atlanta, Georgia, and the office of the secretary for health; 11 editors and contributing editors; 62 contributing authors; 88 reviewers; and 27 other contributors.

An executive summary carries a message from Tommy Thompson, secretary of the Department of Health and Human Services, who said that smoking is too often viewed in the context of men's health.

He highlighted some statistics from the conclusions in the executive summary:

* 3 million women have died prematurely since 1980 because of smoking. On average, these women died 14 years prematurely

* Each year during the 1990s, US women lost an estimated 2.1 million years of life owing to these premature deaths that were attributed to smoking

* 22% of women smoked cigarettes in 1998

* 30% of high school senior girls reported smoking in the past month.

Mr Thompson emphasised the need for prevention, starting with teenage girls and young women. "We must be aggressive in educating them that smoking is very addictive, harmful, and lethal. These young women must know that once they start, it will be difficult to stop--and that the health risks are very real and costly," he said.

The surgeon general, David Satcher, pointed out: "Cigarette smoking is the leading cause of preventable death in the United States, and women's share of tobacco related disease has risen dramatically over the past half century."

Of the six chapters making up the report, one chapter (Health Consequences of Tobacco Use Among Women) is likely to be of most interest to clinicians, covering the relation of tobacco to every body system and its diseases, with 74 pages of references.

The report and executive summary are available at www.surgeon general.gov/library