Q: Are there any differences in the pathogenesis, characteristics and diagnosis and treatment of female lung cancer patients compared with male patients? A: Prof. Wang Jie of Peking University Cancer Hospital: In recent years, the incidence rate of lung cancer is increasing year by year for both men and women in China, but compared with the rate of increase of less than 30% for men, the increase of lung cancer in women is more obvious, which is about 40%. The reasons for this phenomenon may be multifaceted. In recent years, the rising proportion of active and passive smoking among women, as well as the influence of external factors such as environmental pollution and kitchen fumes, have had an impact on the climbing incidence of lung cancer among women. And some intrinsic factors, such as estrogen receptor expression levels and susceptibility gene polymorphisms, are also important causes. Some previous studies have found that estrogen, especially estrogen receptor beta, is more highly expressed in female lung cancer patients, up to 90%; estrogen receptor-related pathways are related to the efficacy of targeted therapy and survival of patients in advanced stages. The susceptibility gene polymorphisms may also contribute to the enhanced susceptibility of some women to lung cancer under the influence of similar extrinsic factors. In addition, women have relatively low DNA repair enzyme function. However, this feature is also a “double-edged sword” for women with lung cancer: on the one hand, it can make women more susceptible to external carcinogenic factors and thus more susceptible to lung cancer; but on the other hand, it also makes women more sensitive to treatment, because chemotherapy destroys DNA while repair enzymes also act to make patients On the other hand, this also makes women more sensitive to treatment, because chemotherapy can damage DNA while repair enzymes are at work to make patients resistant to treatment, but if DNA repair is relatively low, this can make patients more sensitive to treatment. In addition, the cytochrome P450 metabolism of female lung cancer patients has its own characteristics. The above causes and mechanisms of lung cancer pathogenesis in women also contribute to the uniqueness of their disease characteristics. For example, the pathological type of lung cancer in women is mostly adenocarcinoma, whereas in male smokers it is mostly squamous or central small cell lung cancer, so women themselves are a good prognostic factor with a relatively better natural course than men. Moreover, women have a higher rate of epidermal growth factor receptor (EGFR) mutations and may have better efficacy with EGFR-tyrosine kinase inhibitors (TKI). Currently, researchers have also conducted many explorations based on the disease characteristics of female lung cancer. Recently, a small sample study published in the Journal of Clinical Oncology (J Clin Oncol) attempted to add estrogen receptor inhibitors (e.g., tamoxifen) to TKI therapy in female lung cancer patients who are estrogen receptor positive, and initially suggested the prospect of this combination. Therefore, we should pay more attention to the female lung cancer population in the future and conduct more studies to address their own characteristics.