A 60-year-old woman is concerned about cancer and wants to k

A 60-year-old woman comes to the physician for an annual examination. She has no complaints. She had her last menstrual period at age 55 and has had no vaginal bleeding since. She has no medical problems and has never had surgery. She takes no medications and has no allergies to medications. The physical examination is unremarkable. She is concerned about cancer and wants to know which type is the major cause of cancer death in women. Which of the following is the correct response?

A. Breast cancer
B. Cervical cancer
C. Endometrial cancer
D. Lung cancer
E. Ovarian cancer

The answer is D. Breast cancer accounts for the greatest number of new cancer cases in women each year. In 1997, there were 180,200 new breast cancer cases. However, lung cancer is the major cause of cancer death in women. In 1997, lung cancer accounted for 66,000 cancer deaths in women, compared with the 43,900 female deaths caused by breast cancer. There is currently no test used to screen for lung cancer. Smoking cessation is the most effective way to reduce mortality from lung cancer. As stated above, breast cancer (choice A) accounts for the most number of cancer cases in women each year in the U.S., but not the highest number of cancer deaths. Mammography is the screening method used to detect subclinical breast cancer-the stage at which breast cancer is least likely to have spread. Cervical cancer (choice B) is the gynecologic type that causes the fewest number of cancer deaths, partly because of the success of Pap test screening. Pap testing allows preinvasive lesions to be identified and treated, which prevents the progression to invasive disease. Endometrial cancer (choice C) is the most common gynecologic cancer in women older than 45. There is no proven screening test available for endometrial cancer. Ovarian cancer (choice E) is a major cause of cancer death in women. More women die of ovarian cancer than of cervical or endometrial cancer combined. There is no proven screening test available for ovarian cancer.