#HearHer campaign aims to increase awareness of lung cancer among women
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Key takeaways:
- The #HearHer campaign focuses on gender disparities in lung cancer diagnosis and clinical trial enrollment.
- Clinicians should take women’s concerns seriously and make use of imaging for early detection.
Despite tremendous progress in lung cancer treatment and survival the past few decades, one startling trend has emerged.
As recently as the late 1990s, lung cancer occurred less frequently among young women than young men. However, that pattern has shifted considerably.
Data from 2010 to 2014 — the most recent available — showed lung cancer incidence among non-Hispanic white women aged 30 to 49 years exceeding that among non-Hispanic white men.
This pattern — which researchers say cannot be explained fully by differences in smoking behaviors — is compounded by the fact women often face delays in lung cancer diagnosis and treatment initiation. Clinicians also are less likely to offer women lung cancer screening or enroll them in lung cancer clinical trials.
The Florez Lab at Dana-Farber Cancer Institute and Harvard Medical School launched the #HearHer, a social media campaign dedicated to raising awareness about lung cancer among women and emphasizing the needs — and voices — of this patient population.
The effort is imperative given lung cancer incidence among women is expected to continue increasing, according to campaign organizers and leaders Narjust FlorezMD, FASCO, associate director of the Cancer Care Equity Program and thoracic medical oncologist at Dana-Farber Brigham Cancer Center, and Angela Morabito, BS, a research assistant at the Florez lab.
“Anyone with lungs can get lung cancer,” Florez told Healio. “Yet, there are still unconscious biases and stereotypes that are very persuasive and permeate all aspects of medicine. Unfortunately, gender bias continues to play a role in many delays.”
‘Women want to tell this story’
The #HearHer campaign, the launch of which coincided with Lung Cancer Awareness Month in November, is a call to action for physicians and the public, Florez said.
She likened #HearHer’s message to that of Go Red for Women, an American Heart Association initiative designed to educate the public about the importance of cardiovascular health among women.
“The main focus of that campaign is to create awareness about cardiovascular events among women,” Florez said. “Women are often labeled as ‘anxious.’ That same assumption is made about women who present with shortness of breath or chest pressure that turns out to be lung cancer — that they are ‘anxious.’”
This assumption is one example of the implicit biases clinicians may have when it comes to women and lung cancer. Additionally, lung cancer often presents differently among women — particularly patients without a history of previous tobacco use, who account for more than half of women diagnosed with the disease.
“These patients will not have the longstanding history of cough — they just have a cough that doesn’t get better for months,” Florez said. “Their cough also doesn’t sound as wet as it does in patients with history of tobacco use, because these patients, our women, are different.”
Florez recounted the story of a patient who had gone to her primary care physician eight times due to concern about her cough, only to repeatedly be given other explanations for her symptoms.
“Finally, she had a seizure on the way back from picking her kids up at school,” Florez said. “They diagnosed her at that point.”
Florez cited findings from LEAD, an as-yet unpublished study conducted by her team that evaluated the journey to lung cancer diagnosis for women and men.
She wanted to recruit 120 participants in a year. Instead, she enrolled that number in only 4 months.
“These women want to tell this story so badly,” Florez said. “We found that if you are a woman and have a symptom and go to the doctor, it would take you up to six visits to get a lung biopsy. If you’re a man, it may take only two visits. Why are we listening to men and not women?”
How clinicians can help
The #HearHer campaign is represented by a logo of a pair of lungs — one of which is decorated with butterflies and flowers.
The butterflies are meant to memorialize women who have died of lung cancer. The flowers represent hope.
A blue ring around the logo represents its connection to the Florez Lab, known for its commitment to social justice issues and young patients with lung cancer. To date, the lab has shipped more than 1,100 pins to physicians, advanced practice providers, patients and caregivers around the world.
The pins serve as a great conversation starter and also can serve as a teachable moment, Florez said.
She recalled a Transportation Security Administration agent who noticed the pin and asked about it, then expressed the opinion that breast cancer was the number one killer of women.
When Florez told the agent that, in fact, lung cancer kills more women than breast, cervical and ovarian cancers combined, the agent expressed surprise. He then mentioned his mother used to smoke.
“I said, ‘Your mother needs a lung cancer screening,’” Florez said. “All that started with a pin.”
In addition to wearing a #HearHer pin and spreading the word about the campaign, clinicians can play a key role in achieving its mission by following the campaign’s mandate to hear — and take seriously — the concerns of women.
“The main thing is to pay attention, eliminate the bias and escalate,” Florez said. “Especially if the problem is persistent, it warrants closer attention.”
Physicians should not hesitate to make use of imaging when a woman presents with concerns that may be indicative of lung cancer, Florez added.
“Imaging is very important. The clinical picture can look questionable, but imaging is very important,” she said. “It can start with an X-ray. We’re not asking for a CT scan — just a chest X-ray, which can be cost effective in many scenarios.
“Women are being ignored,” Florez added. “This is not only for my patients. This is for everybody. This is for every woman who knows when something is wrong and deserves to be heard.”
Reference:
- Florez lab launches #HearHer campaign to raise awareness of lung cancer in women (press release). Available at: https://docwirenews.com/post/florez-lab-launches-herhear-campaign-to-raise-awareness-of-lung-cancer-in-women. Published Nov. 18, 2024. Accessed Dec. 17, 2024.
- Jemal A, et al. N Engl J Med. 2018;doi:10.1056/NEJMoa1715907.
For more information:
Narjust Florez, MD, FASCO, can be reached at narjust_florez@dfci.harvard.edu. Follow her on X @NarjustFlorezMD.
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