Gender differences in stage at diagnosis and preoperative radiotherapy in patients with rectal cancer

Abstract

Background: Few studies have examined gender differences in the clinical management of rectal cancer. We examine differences in stage at diagnosis and preoperative radiotherapy in rectal cancer patients. Methods: A prospective cohort study was conducted in 22 hospitals in Spain including 770 patients undergoing surgery for rectal cancer. Study outcomes were disseminated disease at diagnosis and receiving preoperative radiotherapy. Age, comorbidity, referral from a screening program, diagnostic delay, distance from the anal verge, and tumor depth were considered as factors that might explain gender differences in these outcomes. Results: Women were more likely to be diagnosed with disseminated disease among those referred from screening (odds ratio, confidence interval 95% (OR, CI = 7.2, 0.9-55.8) and among those with a diagnostic delay greater than 3 months (OR, CI = 5.1, 1.2-21.6). Women were less likely to receive preoperative radiotherapy if they were younger than 65 years of age (OR, CI = 0.6, 0.3-1.0) and if their tumors were cT3 or cT4 (OR, CI = 0.5, 0.4-0.7). Conclusions: The gender-specific sensitivity of rectal cancer screening tests, gender differences in referrals and clinical reasons for not prescribing preoperative radiotherapy in women should be further examined. If these gender differences are not clinically justifiable, their elimination might enhance survival.

Gender oncology: recommendations and consensus of the Italian Association of Medical Oncology (AIOM)

“…If these gender differences are not clinically justifiable, their elimination might enhance survival. 45 8 Further investigation of sex hormones and their association with the efficacy of cancer immunotherapy should be the focus of larger clinical trials to evaluate these parameters as possible prognostic markers. 46 8 Subgroup analyses are important and should be conducted to provide evidence of sex-linked pharmacogenomic markers that should be further studied in larger cohorts of patients.…”

The trend of schistosomiasis related bladder cancer in the lake zone, Tanzania: a retrospective review over 10 years period

“…Several factors are contributing to the observed differences of the advanced stage of bladder cancer between sexes; Firstly, it has been reported that most women with visible haematuria which is the common sign for urinary bladder cancer delay in seeking medical care for diagnosis, possibly due to confusion with menses [ 23 , 57 , 69 ]. Secondly, the thinner bladder wall in females and hormonal differences have been contributing to the variation in grades of urinary bladder cancer between sexes as discussed elsewhere [ 31 , 36 , 38 , 53 , 56 ].…”

Clinical associations for traditional and complementary medicine use among Norwegian cancer survivors in the seventh survey of the Tromsø study: a cross-sectional study

“…This could be due to sex differences in the psychological and physical effects of the disease [ 62 ], and differences in treatment strategies for various reasons like gender bias (where no apparent medical reason justifies why female patients are not offered the same treatment as males [ 63 ]). For example, a recent study showed that female rectal cancer survivors were less likely to receive preoperative radiotherapy than male survivors of the same age, level of comorbidity, and tumor depth [ 64 ]. Furthermore, female survivors have been associated with greater cancer-related distress [ 65 ].…”