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Overall, cancer is the second leading cause of mortality in women. Lung cancer is the most common reason for cancer death in women, followed by breast and colorectal cancers. Strategies for prevention and screening these and other preventable cancers are reviewed below.

1. LUNG CANCER

Although lung cancer is not typically considered a “women’s cancer,” it is the leading cause of cancer mortality in both men and women. Primary prevention of lung cancer should be a high priority with encouragement of tobacco cessation among women who smoke, and screening recommendations for individuals at high risk for lung cancer are discussed in Chapters 1-08 and 39-03.

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Colson  YL  et al. New USPSTF Guidelines for lung cancer screening: better but not enough. JAMA Surg. 2021. [Epub ahead of print]
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Han  D  et al. An Update on the European Lung Cancer Screening Trials and Comparison of Lung Cancer Screening Recommendations in Europe. J Thorac Imaging. 2019;34:65.
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US Preventive Services Task Force; Krist  AH  et al. Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325:962.
[PubMed: 33687470]  

2. BREAST CANCER

RISK FACTORS & RISK ASSESSMENT

Breast cancer is the most detected non-skin cancer in women and the second leading cause of cancer death (see also Chapter 17-07). Breast cancer risk increases with age and with a family history of breast cancer. Women who drink more than two alcoholic drinks per day are at increased risk for breast cancer, and exercise is associated with a decreased risk of breast cancer. Dietary intake has not been conclusively associated with breast cancer risk. Breast density is a risk factor for breast cancer; women with denser breasts as measured with mammography are at increased breast cancer risk. Although some states mandate that women with increased breast density on mammography be notified, it is not currently known what women can do to decrease this risk.

Various models have been used to predict a woman’s risk for breast cancer. The National Cancer Institute has developed the Breast Cancer Risk Assessment Tool (http://www.cancer.gov/bcrisktool/), which is based on the Gail Model, a statistical model that uses the woman’s own personal information to calculate a woman’s risk of developing breast cancer in the next 5 years. Factors that are included are (1) the woman’s age, (2) age at which she had her first menstrual period, (3) age at delivery of first live child, (4) number of first-degree relatives with breast cancer, (5) history of any breast biopsies, and (6) history of atypical hyperplasia. The outcome is a woman’s 5-year risk of developing breast cancer compared with women of the same age and ethnicity. The model has been validated in White women and has been evaluated in Black women and ...

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