516 Women’s Health Psychology
(90,100 men and 67,300 women) and an estimated 169,500
new cases will occur (90,700 among men and 78,800 among
women). According to B. Miller et al. (1996), incidence
rates for lung cancer are higher for Alaska Native women,
African American women, Non-Hispanic White women,
and Hawaiian women (i.e., 43 to 51 per 100,000); lower for
Vietnamese and Chinese women (i.e., 25 to 31 per 100,000);
and the lowest for Hispanic, Filipinos, Korean, and Japanese
women (i.e., 15 to 20 per 100,000). Risk factors for lung
cancer include age, cigarette smoking, asbestos exposure, oc-
cupational exposure (e.g., due to mining), air pollution, and
genetic predisposition. Because of increased smoking rates
among American women, deaths from lung cancer now sur-
pass those from breast cancer (ACS, 2000).
There is a great need to examine cigarette smoking in
women as a function of coping, stress reduction, and the alle-
viation of depression and anxiety, and as a strategy employed
to suppress appetite. Prevention strategies should continue
to focus educational efforts about the risk of lung cancer as-
sociated with cigarette smoking on women, especially on
younger women where the onset of smoking occurs. More-
over, health psychologists should continue to assist in the
development of smoking cessation programs designed to
address concerns speci“c to women, such as weight gain
associated with smoking cessation.
Breast Cancer
Breast cancer is the second leading cause of cancer death
among American women from all age groups and remains the
leading cause of cancer death among women ages 15 to 54
(ACS, 2000). It is estimated that 192,200 new cases of
breast cancer will occur (1,500 men) and 40,600 individuals
will die from breast cancer in 2001 (40,200 women and
400 men). While European American women have a higher
age-adjusted incidence rate of breast cancer, African American
women are almost 30% more likely to die from breast cancer
than European American women. Positive news is that the
mortality rates for breast cancer declined during 1990 to 1997,
with the largest decreases among younger women.
Risk factors for breast cancer include current age, age at
menarche, age at menopause, age at “rst full-term pregnancy,
family history, obesity, and physical inactivity (ACS, 2000;
Ursin, Spicer, & Bernstein, 2000). Risk for breast cancer
increases with age, with 77% of women being over the age
of 50 at the time of diagnosis (ACS, 2000). Likewise,
women with a “rst-degree relative with breast cancer are
twice as likely to develop breast cancer. Women who start
menstruating before age 12, reach menopause at a late age
(i.e., 55 years or later), experience a “rst pregnancy after the
age of 30, or have no children, have a slightly higher risk of
developing breast cancer (ACS, 2000). Last, obesity and
physical inactivity are associated with greater risk of devel-
oping breast cancer. Studies have indicated that protective
factors against breast cancer include exercise, maintaining
ideal body weight, breastfeeding, reduced alcohol consump-
tion, and avoidance of long-term hormone replacement
therapy (see Kerlikowske, 2000, for a review).
In part because of the efforts of women•s health advocacy
groups, breast cancer research is one of the few areas perti-
nent to women•s health that has received a tremendous
amount of attention. In the past decade, there has been a pro-
liferation of breast cancer studies, with a particular focus on
treatment choices and •psychosocial interventionsŽ and out-
comes (Rowland, 1998). In other words, research has focused
not only on medical treatment options, but also on the
psychological and sociological effects of the disease (e.g.,
coping skills and importance of social support). In addition,
numerous educational programs stress the importance of
routine screening, and attempts have been made to make
mammography accessible to all women. Consequently,
women with breast cancer are being diagnosed in the earlier
stages of the disease when the chance for recovery is 70% or
greater (Rowland, 1998). Health care providers also have in-
creased the use of •breast-sparing approachesŽ and adjunc-
tive treatment such as chemotherapy, radiotherapy, and
hormonal therapy. As a result, women are provided with
treatment choices, and fewer have to undergo the more ag-
gressive treatments that can greatly impact women•s body
perception and self-identity (e.g., mastectomy). In addition to
increasing awareness of breast cancer and treatment options,
health psychologists can help women diagnosed with the dis-
ease and their families adjust to what can be traumatic effects
of surgery, as well as manage side effects associated with
nonsurgical intervention, such as anticipatory nausea, hair
loss, and fatigue.StrokeStroke, the third leading cause of death for American men
and women, occurs as a result of a blocked or ruptured artery.
The brain is then deprived of needed oxygen and brain cells
begin to die. Stroke occurs at a higher rate among African
American and Latina women compared to European
American women (CDC, 1999). Risk factors for men and
women include high blood pressure, cigarette smoking, dia-
betes, and high cholesterol (Wolf, 1990), but biological sex
is a determinant in the prevalence of these risk factors and in
the etiology of stroke. Arboix and colleagues (2001) noted
that limited research is available examining gender-related