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Cancer incidence higher for men than women
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Results of an analysis of 5-year OS for 36 cancers showed that men in the US are more likely than women to receive a cancer diagnosis.
Researchers added that the overall mortality rate was higher for men with cancer compared with women, but survival rates were not markedly different between the sexes.
Researchers determined that age-adjusted mortality rates were higher for men than women for all cancers studied except peritoneum, omentum, and mesentery. The age-adjusted male-to-female mortality rate ratio was highest for lip cancer, of which 5.51 men died for every one woman, followed by larynx (5.37-to-1), hypopharynx (4.47-to-1) and esophagus (4.08-to-1) cancers. Cancer-specific survival was also worse for men in most cancers but disparities were not nearly as great.
Michael B. Cook, PhD, an investigator in the division of cancer epidemiology and genetics at the NCI and one of the study's authors, said the results likely reflect that sex disparities in cancer mortality arise from disparities in cancer incidence.
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"It's the sex differences in cancer incidence that really matter," he told HemOnc Today. "Although there are some sex differences in survival, the real message of our paper is, 'Why is there a sex disparity in cancer incidence and how can we understand it so we can give preventative advice to reduce the cancer burden?'"
The results were published online July 12 in Cancer Epidemiology, Biomarkers & Prevention.
Cook et al used records from the SEER database to calculate cancer mortality counts and rates per 100,000 person-years for each cancer as stratified by sex for the periods 1977-1986, 1987-1996, 1997-2006 and 1977-2006. Sex-specific cancers were excluded, and researchers adjusted for age, year of diagnosis and tumor stage and grade.
Predictably, 5-year OS was poorer for men, although Cook said the differences were not pronounced. Survival was worst for men with basal and squamous cancers (HR=1.58; 95% CI, 1.52-1.64); cancers of the endocrine system (HR=1.32; 95% CI, 1.24-1.42); and cancer of the floor of the mouth (HR=1.32; 95% CI, 1.07-1.63).
Cause-specific mortality in men was lower relative to women for urinary bladder cancer (HR=0.83; 95% CI, 0.81-0.86) and tongue cancer (HR=0.89; 95% CI, 0.83-0.95).
Cook said the next step is to unlock the reasons why incidence is higher in men. The factors driving the disparity in incidence could be biologic, environmental or both, he said.
"Are there some general features about men and women that make men more susceptible and women more protected?" Cook said. "Or is it a question of exposures? Is it that men consume more alcohol, smoke more cigarettes, store their fat in the gut region which is know to be more metabolically active? How do all of these differences play into specific types of cancer?" – by Jason Harris
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Disclosure: Dr. Cook reported no relevant financial disclosures.
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