CERS1 and cancer: Surprisingly, the ceramide synthase 1 (CERS1), the key enzyme for ceramide synthesis, was equally expressed in non-cancerous lung tissues of males and females (Figure 4B; non-cancer CERS1 mean expression: male −1.04 and female −0.969 p = 0.27), but its transcription was significantly decreased in females with SCC compared to males (Figure 4C; Cancer CERS1 mean expression: male −0.69 and female −0.798 p = 0.044).