The Link Between Estrogen and Lung Cancer

Woman with hormone replacement pill pack
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Is there a link between estrogen and lung cancer? We know there are many differences between lung cancer in women and lung cancer in men. We also know that lung cancer cells have estrogen receptors, that is, areas on the surface of the cell that can bind with estrogen. Though our knowledge is far from complete at this time, what might this mean for women with lung cancer today, or at risk for lung cancer in the future?

Before talking about the studies, it is helpful to explain why some of the results may be very confusing. There are probably several different ways (mechanisms) by which estrogen plays a role in lung cancer. It is also important to point out that many of these studies are talking about two very separate issues. One is causation—might a higher or lower level of estrogen have an effect on whether someone will develop lung cancer in the first place? The other is a progression—could estrogen cause lung cancer that is already present to grow faster or slower?

Reproductive History

Though we understand that breast cancer is more common in women who begin having periods at a younger age, studies have not found this to be the case with lung cancer. Lung cancer was thought to be somewhat less common in women who have had more children than in those who have had fewer children or none at all, especially in women who have never smoked. A recent evaluation of studies to date suggests that non-small cell lung cancer, but not small cell lung cancer, may be slightly less common in women who have had more children. One study found that, in contrast to breast cancer, lung cancer risk was slightly lower when women gave birth at a later age. (In comparison, with breast cancer the risk is reduced by having a first child early in life (before 30) but lung cancer risk is slightly reduced by having a child later in life.)

A recent study suggests that women who have both of their ovaries removed (“surgical menopause”) may have an elevated risk of developing lung cancer. Some studies have also shown a small correlation between early menopause and the development of lung cancer.

Animal Studies

One study on mice suggested that estrogen may promote the growth of lung cancers. In that study, female mice that had ovaries developed more lung tumors than female mice that had their ovaries removed. In addition, when the mice without ovaries were treated with estrogen, their tumors grew faster than mice that weren’t treated with estrogen.

Hormone Replacement Therapy

Combination hormone replacement therapy or HRT (estrogen and progesterone) for menopausal symptoms may increase the risk of dying from lung cancer, especially in people who smoke. In a study of 16,000 women with non-small cell lung cancer, those who were using combination hormone replacement therapy were 60 percent more likely to die from the disease. It’s important to note that in this study, the combination HRT increased the risk of death from lung cancer if they already had it, but not the chance that someone would develop lung cancer. Overall, studies looking at combinations as a cause of lung cancer have been mixed, with some showing an increase, some showing no association, and some newer studies actually showing a decrease in lung cancer risk.

A Recent PLoS review looked at the role of estrogen therapy (without progesterone) alone on the risk of lung cancer in women as part of the California Teachers study. In this study, there was no association (no increase or decrease) between the use of combination therapy (estrogen plus progesterone) and the risk of lung cancer. However, for women who used estrogen therapy alone, former users of estrogen with a short duration of use (less than 5 years) had a lower risk of dying from lung cancer (46 percent less likely), and recent users of estrogen with a longer duration of use (greater than 15 years) also had a lower risk of dying the disease (40 percent less likely).

One study found a lower of lung cancer among women who had used oral contraceptive pills.


The intake of plant-based estrogens (phytoestrogens), such as those found in soy, have been looked at in a few studies with lung cancer. In some of these, it appeared that women who consume a diet higher in phytoestrogens have a lower incidence of lung cancer, especially among women who have never smoked.

Bottom Line

Since lung cancer is, in many ways, a different disease in women, it is important to look at the possible role of estrogen. But as noted above, what we understand about estrogen and lung cancer is still in the early stages.

With any procedure or medication, it is extremely important to weigh the benefits of treatment against the possible risks. For example, if your doctor recommends that you have your ovaries removed for some reason, the benefit of the procedure may far outweigh a possible increase in lung cancer risk.

For now, these studies are a good reminder to talk with your doctor if you are on hormone replacement therapy, particularly if you smoke, and to ask questions. Do you need to take the medications? Are there any alternatives? Are there benefits that go beyond the potential risk of a higher mortality from lung cancer (or breast cancer)?

On a final note, understanding that lung cancer cells have estrogen receptors opens doors that perhaps some of the medications used traditionally for breast cancer could have a role in the treatment of lung cancer in the future.

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