In the late 1960s, when the feminist movement progressed, the Phillip Morris tobacco company advertised its cigarette brand Virginia Slims on TV with the catchy phrase: “You’ve Come a Long Way, Baby.” The deadly product significantly shortened the life of its users, inducing women to join men developing lung and throat cancer and other diseases. Only in 1971 did the US government bring an end to all tobacco ads on TV and radio. 

Today, Israeli health authorities report an increase in the number of women suffering from lung cancer and in the number of those dying from it – probably as a result of the increase in the rate of smokers in the past. 

To mark International Month for the Advancement of the Fight Against Lung Cancer, the Israel Cancer Association (ICA) and the Health Ministry in Jerusalem published updated data regarding on lung cancer in the country. 

 Lung cancer is the second most common cancer in the Western world and a major cause of cancer mortality. It is the most common type of cancer among Israeli-Arab men and among the most common among Jewish men, Jewish women and Arab women, both in terms of morbidity and mortality. This disease is usually detected at an advanced stage, so the chances for survival are low. 

According to the ministry’s National Cancer Registry, in 2017 there were 2,613 new lung cancer patients, of whom 37.3% were women; this compared with the 2007 figure of 2,114 new lung cancer patients, of which 35.3% were women. In 1997, there were 1,484 new cases, of which 29.1% were women. Thus, both the absolute number of patients and the proportion of women has increased in all population groups in the last two decades. 

The risk of lung cancer in Israel among the Jewish population and others (non-Arab Christians and those without religious classification) is 27.3 per 100,000 men and 15.7 per 100,000 women. Among the Arab population, the corresponding indices are 44.3 in men and 6.5 in women per 100,000.

According to Prof. Lital Keinan-Boker, director of the ministry’s Center for Disease Control, the lung cancer rate has decreased since 1997 among Jewish men in Israel, and remained steady among Arab women and steady but very high in Arab men, but it has risen in Israeli women. Most of those diagnosed with lung cancer are aged 70 and over. 

The data show that in 2017, 1,842 Israelis died of lung cancer, of which 33.2% were women. Ten years before that, 1,551 Israelis died it,, of which 32.6% were women, while in 1997, 1,163 people in Israel died of lung cancer, of which 29.9% were women. 

Calculating the relative survival rate from lung cancer over five years showed that despite a small improvement in recent years, lung cancer remains a deadly disease even among young patients. The survival rate among Jews (and others) and Arabs is similar. Among women the survival rate is slightly higher than in men. 

ICA director Moshe Bar-Haim commented that “cigarette smoking is the most significant and critical risk factor for the development of lung cancer. Active or passive cigarette smoking is the cause of about 80% of lung cancer deaths. In recent years, in addition to cigarette smoking, we have seen a steady increase in the use of e-cigarettes, the addiction to that is stronger than that to regular cigarettes, and the use of hookah among young people. Keep in mind that the likelihood of developing lung cancer is higher among people who start smoking at a young age. It is important to know that a person who quits smoking significantly reduces his risk of getting sick – most importantly remember that smoking is the leading preventable risk factor.” 

Bar-Haim added that the most effective step against the smoking phenomenon is to raise the tax on smoking products, “and this is the main strategy to reduce cancer deaths and prevent the onset of smoking among young people and adolescents. I call on youth and young people – do not start with the addictive and deadly habit and stay away from cigarettes.” 

Meanwhile, researchers from Korea and the US have examined the link between taking aspirin (an anti-inflammatory and pain-relieving drug), statins (for lowering “bad” cholesterol) and metformin (a drug for treating type-2 diabetes) and the incidence and mortality from lung cancer. The study was recently published in the Journal of Thoracic Oncology. They followed 732,199 people aged 49 to 70 who underwent a lung scan in Korea over a period of several years. 

Analysis of the results found that there was no association between past aspirin use and lung cancer incidence or mortality, but cumulative aspirin use was found to be associated with a 13% reduction in lung cancer mortality. A high was found to be associated with a 23% reduction in the risk of lung cancer deaths.

Compared to participants without diabetes, any past use of metformin was found to be associated with an 11% reduction in the risk of lung cancer. Cumulative high use of metformin has been associated with a 66% reduction in the risk of lung cancer and a 23% risk of dying from the disease. Combined use of aspirin, statins, and metformin has also been shown to be associated with a 17% reduction in the risk of developing and dying from lung cancer. The longer the medications were taken together, the stronger the protective bond of this drug combination.

The researchers hypothesize that simultaneous use of the three drugs inhibits multiple pathways associated with the growth of lung cancer cells. Therefore, the researchers point out that these drugs may be able to provide simple and accessible preventive approaches to people at high risk for lung cancer. But further studies are needed to develop clinical guidelines for the use of these drugs to reduce the incidence and mortality of lung cancer. 

The link between tobacco smoking and the risk of lung cancer has long been known, but now it has been shown that up to 40% of lung cancer patients may develop the spread of cancer to the brain, for which treatment options are limited, as most drugs are unable to cross the blood-brain barrier. 

Researchers from Wake Forest Medical Center in North Carolina recently published in the Journal of Experimental Medicine that the nicotine in tobacco actually encourages the spread or development of metastases of lung cancer cells in the brain. Non-smoking nicotine products, such as e-cigarettes, and products such as chewing gum and nicotine patches, are often offered as aids in rehab, but researchers warn that in light of the study’s findings, caution should be exercised in using these products.