Sex Differences in Lung Cancer

May, Lauren; Shows, Kathryn; Nana-Sinkam, Patrick; Li, Howard; Landry, Joseph W.

doi:10.3390/cancers15123111

Cited by 28 publications

(9 citation statements)

References 174 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings are in line with the study by Owonikoko et al on >300,000 elderly patients with lung cancer [44]. May et al recently addressed these genderspecific differences in a review article [45]. Furthermore, we found better outcomes in patients with higher Karnofsky index (≥80).…”

Section: Discussionsupporting

confidence: 92%

Outcomes of Multimodal Treatment in Elderly Patients with Localized Non-Small Lung Cancer from a Radiation Oncology Point of View: Special Focus on Low-Dose Cisplatin

Alt,

Muster,

Ziegler

et al. 2024

Cancers

View full text Add to dashboard Cite

Identification of the optimal treatment strategy is challenging in elderly with localized non-small cell lung cancer (NSCLC). Concurrent chemotherapy with low-dose cisplatin represents an option for elderly. Outcomes (1) in elderly (≥70 years, n = 158) vs. younger patients (n = 188) and (2), independently of age, in definitive radiochemotherapy, with low-dose cisplatin (n = 125) vs. cisplatin/vinorelbine (n = 76) were studied. Elderly included more males, had a lower Karnofsky index, more comorbidities, and lower stages. Low-dose cisplatin patients (vs. cisplatin/vinorelbine) had higher age, more comorbidities, and lower stages. We observed reduced dermatitis and dysphagia and increased anemia and thrombocytopenia in elderly vs. younger patients, without increased ≥grade 3 toxicities. Low-dose cisplatin was less toxic than cisplatin/vinorelbine. Survival outcomes were lower in elderly vs. younger and comparable between low-dose cisplatin and cisplatin/vinorelbine. In elderly, gender, Karnofsky index, stage, and multimodal treatment (including additional surgery/systemic therapy) were identified as prognostic factors. In conclusion, we found evidence for an acceptable toxicity profile and the need for improvement of outcomes in elderly with localized NSCLC. Multimodal strategies (including additional surgery/systemic treatment) showed favorable outcomes and should be reasonably considered in elderly who are deemed fit enough. Low-dose cisplatin should be discussed on an individual basis due to favorable toxicity and outcomes.

show abstract

Section: Discussionsupporting

confidence: 92%

Outcomes of Multimodal Treatment in Elderly Patients with Localized Non-Small Lung Cancer from a Radiation Oncology Point of View: Special Focus on Low-Dose Cisplatin

Alt,

Muster,

Ziegler

et al. 2024

Cancers

View full text Add to dashboard Cite

show abstract

“…While not a sex-specific cancer, lung cancer shows sex-specific trends in our data as well as has been reported nationally and internationally [47][48], [49]. A recent review attributed this finding to many factors such as the slower relative reduction in female smoking compared to males[8], [48], coupled with females being exposed to different risk factors, as well as differences in oestrogen levels [48], exposure to human papillomavirus (HPV) [50] and genetic polymorphisms [48].…”

Section: Discussionsupporting

confidence: 82%

“…Although incidence and prevalence are increasing in females, overall survival is better in females compared to males in line with a similar study using primary care data from the UK [27]. Again, reasons for this difference are likely to be multifactorial involving different risk factors, treatment decisions, and cancer histology [47]. Survival from lung cancer has substantially improved since 2000, which has corresponded with major advancements in lung cancer treatments [2], [12].…”

Section: Discussionsupporting

confidence: 67%

Incidence, prevalence, and survival of lung cancer in the United Kingdom from 2000-2021: a population-based cohort study

Corby,

Barclay,

Tan

et al. 2024

Preprint

View full text Add to dashboard Cite

BackgroundLung cancer is the leading cause of cancer-associated mortality worldwide. In the UK, there has been a major reduction in smoking, the leading risk factor for lung cancer, as well as the introduction of the new screening in 2023. Therefore, an up-to-date assessment of the trends of lung cancer is required in the UK.MethodsWe performed a population-based cohort study using the UK primary care Clinical Practice Research Datalink (CPRD) GOLD database, compared with CPRD Aurum. Participants aged 18+ years, with one-year of prior data availability, were included. We estimated lung cancer incidence rates (IR), period prevalence (PP), and survival at one-, five– and ten years after diagnosis using the Kaplan-Meier method.ResultsOverall, 11,388,117 participants, with 45,563 lung cancer cases were studied. The incidence rate of lung cancer was 52.0 (95% CI 51.5 to 52.5) per 100,000 person-years, with incidence increasing from 2000 to 2021, especially in females aged over 50, and males aged over 80, with the highest incidence rate in people aged 80-89. Period prevalence in 2021 was 0.18%, with the largest rise seen in participants aged over 60. Median survival post-diagnosis increased from 6.6 months in those diagnosed between 2000-2004 to 10 months between 2015-2019. Both short and long-term survival was higher in younger cohorts, with 82.7% one-year survival in those aged 18-29, versus 24.2% in the age 90+ cohort. Throughout the study period, survival was longer in females, with a larger increase in survival over time than in males.ConclusionThe incidence and prevalence of lung cancer diagnoses in the UK have increased, especially in female and older populations, with a small increase in median survival. With the introduction of the UK lung cancer screening programme, this study will enable future comparisons of overall disease burden, so the overall impact may be seen.

show abstract

“…This result was consistent in subgroup analysis of both Asian (OR, 0.90; 95% CI: 0.84–0.99) and Western (OR, 0.90; 95% CI: 0.84–0.96) females, though for distinct underlying causes of exposure ( 34 ). However, there is evidence suggesting estrogen exposure via hormone replacement therapy may in fact increase lung cancer risk in women ( 8 , 30 , 35 , 36 ).…”

Section: Risk Factorsmentioning

confidence: 99%

Lung cancer in females—sex-based differences from males in epidemiology, biology, and outcomes: a narrative review

Gee,

Yendamuri

2024

Transl Lung Cancer Res

View full text Add to dashboard Cite

Background and Objective The role of biological sex is seldom considered in characterizing lung cancer, the deadliest cancer in both the United States and the world. Lung cancer has traditionally been regarded as a male disease; as such, research in female-specific phenomena is frequently conflicting or absent. Currently, disparities in lung cancer incidence are primarily driven by females, especially non-smokers and those of younger age. This narrative review provides insight into sex-specific characteristics of lung cancer, highlighting risk factors, diagnosis patterns, carcinogenesis, and treatment outcomes in females. Methods The PubMed database was searched on July 26, 2023 to identify research published between 2013 and 2023 in English. Sixty-three articles were considered relevant, and their full texts and citations were studied to compile information for this narrative review. Key Content and Findings Exposure-related risk factors, including personal tobacco use, are thought to impact female lung cancer risk more profoundly. However, studies on occupational exposures are underpowered to conclude risk in females. Data characterizing the effect of endogenous and exogenous hormonal exposures on female lung cancer risk remain two-sided. Screening guidelines are tailored to white males, exacerbating sex and race disparities. The effect of biological sex on carcinogenesis and the immune system response to cancer is not fully understood, though the female immune system clearly reacts more aggressively to lung cancer. In early-stage disease, females have greater survival in the perioperative setting and during follow-up of several years, attributed to favorable histopathology and healthier baseline status. Sex-specific response to systemic treatment continues to be optimized as lack of standardization in randomized trials makes interpreting results difficult when aggregated. Conclusions Biological sex plays a critical role in non-small cell lung cancer (NSCLC), though further study is needed to depict the complex web of factors that affect lung cancer risk, development, and outcomes. Female underrepresentation in studies has contributed to this lack of understanding. As these disparities are eliminated, we can move towards more effective treatment for both sexes in this pervasive yet deadly disease.

show abstract

Sex Differences in Lung Cancer

Cited by 28 publications

References 174 publications

Outcomes of Multimodal Treatment in Elderly Patients with Localized Non-Small Lung Cancer from a Radiation Oncology Point of View: Special Focus on Low-Dose Cisplatin

Outcomes of Multimodal Treatment in Elderly Patients with Localized Non-Small Lung Cancer from a Radiation Oncology Point of View: Special Focus on Low-Dose Cisplatin

Incidence, prevalence, and survival of lung cancer in the United Kingdom from 2000-2021: a population-based cohort study

Lung cancer in females—sex-based differences from males in epidemiology, biology, and outcomes: a narrative review

Contact Info

Product

Resources

About