Geschlechtsspezifische Unterschiede beim Lungenkarzinom

Zusammenfassung

Epidemiologisch zeigt sich in Deutschland, in Europa und in den USA eine zunehmende Lungenkrebshäufigkeit bei Frauen! Besonders der Vergleich der altersspezifischen Erkrankungsraten nach Geschlecht zeigt bei jüngeren Frauen eine höhere Lungenkrebserkrankungsrate als bei Männern. Histologisch sind bei Frauen mehr Adenokarzinome als bei Männern zu beobachten. Ursächlich sind einerseits sicherlich die geänderten Rauchgewohnheiten der Frauen, zusätzlich spielen aber noch andere Faktoren bei der Lungenkrebs-Karzinogenese der Frauen eine Rolle. Wesentlich häufiger manifestiert sich der Nichtraucher-Lungenkrebs bei Frauen als bei Männern. Ursächlich könnten unterschiedliche Lungenkrebs-Empfänglichkeiten oder auch unterschiedliche Karzinogen-Expositionen, z. B. gegenüber Radon, durch Passivrauchen oder Herddämpfe der Geschlechter sein. Auf molekularer Ebene finden sich bei Frauen häufiger genetische „Treiber-Mutationen“ als bei Männern und demzufolge können neue „zielgerichtete Therapien“, z. B. gegen EGFR oder Alk, häufiger bei Frauen zum Einsatz kommen. Die Prognose beim klein- und nichtkleinzelligen Lungenkarzinom ist bei Frauen insgesamt etwas besser als bei Männern.

Abstract

More and more differences in lung cancer are being detected between men and women. Lung cancer, at the beginning of the last century a rare disease in women, has a growing incidence in women, in particular in young females. Lung cancer is a leading cause of cancer death in women in developed countries with different histological types and adenocarcinomas are more frequent in women than in men. Cigarette smoking is the most prevalent cause of lung cancer in women, in addition susceptibility to carcinogens may differ between the sexes. As more non-smoking women than men develop lung cancer, it is likely that they are exposed to excessive environmental carcinogens such as second-hand-smoking, in-house-radon or cooking fumes. Furthermore, genetic and hormonal influences play a role in lung cancer etiology for women. Taken together, women have a better overall survival than men with lung cancer. Differences in molecular susceptibility patterns are observed between men and women, and show that molecular targets such as EGFR or ALK more frequent in women.

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