Younger Women Are Now More At-Risk for Cancer Than Men
Trends in breast, prostate and lung cancer are shifting who is most at-risk
The face of cancer in the U.S. is getting younger—and more feminine.
Cancer rates for women in the U.S. have risen over the past half-century, particularly among women under age 65 diagnosed with breast cancer, the American Cancer Society said Thursday. Men, meanwhile, have experienced a decline in cancer rates compared with prior decades.
“If you’re a woman under the age of 65, you’re now more likely to develop cancer than a man” in that same age group, said Dr. William Dahut, the American Cancer Society’s chief scientific officer.
For decades, the cancer burden in the U.S. was higher for men, who started smoking en masse in the 20th century. Their rates of lung-cancer cases and deaths soared. Lung cancer remains the biggest cancer killer for men in the U.S., but case and death rates have dropped, after smoking rates declined.
Women started smoking heavily later than men and have been slower to quit, so their lung-cancer decline started later and hasn’t been as steep.
That has had a significant impact: Lung cancer incidence among women under 65 was greater than among men for the first time in 2021. Women are also more likely to get diagnosed with lung cancer as nonsmokers.
“This is really a transformational change,” Dahut said.
The overall cancer death rate in the U.S. has dropped 34% since 1991, the report said, translating to nearly 4.5 million fewer deaths. The progress is largely thanks to the declines in cigarette smoking, as well as better cancer screenings and treatments. The number of averted deaths is twice as large for men than for women.
About 1.1 men were diagnosed with cancer for each case among women in 2021. That is down from a high of 1.6 diagnoses among men for each woman in 1992.
Men’s overall cancer rates spiked in the early ’90s, when widespread prostate-cancer screening led to a surge of small, low-risk prostate cancers, in addition to dangerous cases being caught earlier. When doctors pulled back on the tests, which look for levels of prostate-specific antigen in blood, case rates dropped nearly 40%, the report said. They remain below that peak.
“We’re doing a better job detecting cancers that need to be tracked and followed,” said Dr. Stephen Gruber, a cancer epidemiologist and geneticist at City of Hope in Duarte, Calif. “We’re not just blasting everybody with PSA testing.”
Breast-cancer rates have increased about 1% each year over the past decade, with steeper rises among younger women, contributing to the flip in cancer risk. In 2007, cancer rates for women between 50-64 were 21% lower than for their male peers. In 2021, women’s rates passed men’s.
Among adults under 50, women already faced a higher cancer risk. The cancer rate for these women was 82% greater than for their male peers in 2021, compared with 51% higher in 2002, because of thyroid and breast cancers. Increases in colorectal and testicular cancers among younger men were offset by declines in others including prostate.
“The change in cancer among women, especially younger women, is really shocking,” said Dr. Karen Kim, a health disparities researcher and dean of the Penn State College of Medicine.
More women having children later or not at all likely contributes to the trend, because having children at earlier ages and breastfeeding lower the risk of some kinds of breast cancers. Increasing obesity rates, physical inactivity and rates of heavy alcohol consumption among younger women are also potential factors, researchers said.
The breast-cancer death rate has dropped 44% since 1989, thanks to better treatments and screening. It is still the leading cause of cancer death for women under 50.
