For certain types of lung cancer, women appear to have significantly better survival rates than men, according to the first study to use highly accurate, commonly available techniques to properly stage the disease.

In the first study to use both surgery, CT and PET scans to most accurately stage -non small-cell lung cancer, University of Alabama at Birmingham (UAB) researchers found that, for stages I through III, the five-year survival rate of women was far better than men. The study is published in the December issue of Chest.

Lung cancer is the leading cause of cancer deaths, taking more female lives in America than the next three most common forms of female cancers (breast, colorectal and ovarian) combined. It also kills more American men than the next three most common forms of cancer in men - prostate, colorectal and pancreatic. Though the incidence of lung cancer has declined in men, it has risen sharply in women, making it likely that men and women will suffer from lung cancer at the same rate over the next decade.

“Given these trends, we wanted to prospectively study this issue because previous reports have suggested that women with non-small cell lung cancer fare better than men, but these studies have been registry or statistical based and may be flawed by their retrospective nature or inaccurate data,” said lead author and study designer, Robert J. Cerfolio, M.D., professor of surgery and chief of thoracic surgery at UAB. “For this study, we wanted to have the most accurate data available for study. To this end, our patients underwent the best clinical staging available followed by careful intra-operative pathologic staging.”

Cerfolio evaluated 1,085 patients- 671 men and 414 women - between January 1998 and March 2005 at UAB Hospital. Race, co-morbidities, smoking rates, pulmonary function tests, chemotherapy rates and resection rates were similar between men and women. Women, however, were younger than men, presented at an earlier stage of the disease and had a higher incidence of adenocarcinoma.

The study found that overall, 60 percent of women were alive at the five-year mark, compared to 50 percent of the men in the study. For those diagnosed at stage I, 69 percent of women versus 64 percent of men were alive at five years out; in stage II at five years 60 percent of women were alive versus 50 percent of men; and for stage III, five year survivability was 46 percent for women and 37 percent for men.

“We found that women had better survival rates at all three stages than men, even when we adjusted for other factors, including age and histology,” Cerfolio said. “The possible causes include biologic, hormonal and molecular factors that differ between genders. The complex array of known and unknown factors that affect survival means further research is needed to better understand the mechanisms that make women fare better than men.”

In addition to Cerfolio, authors on the study were: Ayesha S. Bryant, M.D., M.S.P.H., statistician, UAB Department of Surgery; Fransisco Robert, M.D., UAB professor of medicine, Division of Hematology and Oncology; Sharon A. Spencer, M.D., UAB professor of radiation oncology; and Robert I. Garver, M.D., UAB professor of medicine, Division of Pulmonary/Allergy/Critical Care.