麻豆传媒

SAN DIEGO -- While pulmonary diseases tend to be more likely to hit males, physicians cautioned colleagues this week that female patients with lung diseases face unique risks, such as different and more severe symptoms compared with men. Still, there are no separate guidelines for treatment of women for conditions like lung cancer, leaving specialists to figure out their own best practices.

In idiopathic pulmonary fibrosis, for example, physicians should be aware that women tend to experience more shortness of breath than men and suffer more emotion-related disruptions of quality of life, said Timothy P. Whelan, MD, of the Medical University of South Carolina in Charleston, speaking in a session about women and lung disease at the annual meeting of the American Thoracic Society.

Men with lung diseases, in contrast, report more physical-related disruptions of quality of life.

"This is a good reminder that when you're talking to your patients, the way it's affecting the women may be a little bit different," Whelan said. "Maybe pulmonary rehab isn't as important to them from a physical perspective, but a big selling point would be an opportunity to be around a social network and be able to do more."

Gender differences in lung diseases have gained more attention in recent years. As a put it, "there is growing evidence that a number of pulmonary diseases affect women differently and with a greater degree of severity than men."

Some lung conditions occur only in women, including catamenial pneumothorax (linked to menstruation), pregnancy-associated asthma exacerbation, and lymphangioleiomyomatosis. The latter condition has a prevalence of 1-10 per million, Whelan noted. The typical age at presentation is mid-30s to mid-40s, and there are no known risk factors, although smoking is associated with progression.

Patients with the condition are often misdiagnosed as having asthma or chronic obstructive pulmonary disease, he said. "Delays in diagnosis are extremely common. Pneumothorax brings it to our attention, but two-thirds of patients do not have that."

High-resolution CT scanning is key to detection, which could also help reduce the lengthy delays -- years in some cases -- before patients are properly diagnosed, Whelan said.

Chronic obstructive lung disease (COPD) is another lung disease with a gender disparity, said another speaker at the session, Tatsiana Beiko, MD, also of the Medical University of South Carolina.

COPD, which she called a disease of low socioeconomic status, is more common in women: "As household income decreases, the prevalence rises. The prevalence among women is higher than among men, and traditionally, women-based households have less income."

According to the (ALA), seven million women in the U.S. have COPD, and "the number of deaths among women from COPD has increased fourfold over the past 3 decades and, since 2000, more women than men in this country have died of the disease."

Additionally, the ALA states, research shows that women diagnosed with COPD experience higher rates of anxiety and depression and report lower quality of life.

For lung cancer, men are still more likely to die of the disease than women are, said Brett Bade, MD, of Yale University School of Medicine in New Haven, Conn., also speaking at the session. However, the death rate from lung cancer among women in the U.S. started to plateau only over the last 5 years, later than the similar trend in men, he said.

The explanation for the difference may lie in the patterns of smoking in men and women over the last several generations. Women began smoking more after World War II, and men achieved higher cessation rates from 1965 to 1985.

Research suggests that women are diagnosed with lung cancer at younger ages than men and are more likely to be non-smokers, Bade said. Survival in women is also higher.

In addition, he noted, there are multiple biological and genetic differences in lung cancer development between men and women. Even so, there are no different recommendations for women in terms of lung cancer screening or treatment.

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