Why do men get more cancer than women?

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Peer-reviewed: This work was reviewed and scrutinised by relevant independent experts.

Observational study: A study in which the subject is observed to see if there is a relationship between two or more things (eg: the consumption of diet drinks and obesity). Observational studies cannot prove that one thing causes another, only that they are linked.

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Rates of most types of cancer are higher in men than in women and new research suggests this might be because of differences in our biology rather than differences in lifestyle factors. The researchers looked at the risk of 21 cancers among more than 150,000 men and 100,000 women aged 50–71 years who were part of a 15 year study. They found that men had a higher risk of most cancers, even after taking into account a wide range of risk behaviours, such as smoking and drinking. They say the findings suggest that biological differences between sexes—such as physiological, immunological, genetic, and other differences—play a major role in the cancer susceptibility of men versus women.

Journal/conference: CANCER

Link to research (DOI): 10.1002/cncr.34390

Organisation/s: National Institutes of Health, USA

Funder: This research was supported in part by the Intramural Research Program of the National Institutes of Health, National Cancer Institute. Morgan A. Marks performed this work as a postdoctoral fellow at the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland. The funding source had no role in the study design, data analysis, interpretation of the results, or the decision to publish this article.

Media release

From: Wiley

Why do men face a higher risk of most types of cancer than women?

Study findings suggest that biological sex differences may be the answer.

Rates of most types of cancer are higher in men than in women for reasons that are unclear. Results from a recent study published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society, suggest that the cause may be underlying biological sex differences rather than behavioral differences related to smoking, alcohol use, diet, and other factors.

Understanding the reasons for sex differences in cancer risk could provide important information to improve prevention and treatment. To investigate, Sarah S. Jackson, PhD, of the National Cancer Institute, part of the National Institutes of Health, and her colleagues, assessed differences in cancer risk for each of 21 cancer sites among 171,274 male and 122,826 female adults aged 50–71 years who were participating in the NIH-AARP Diet and Health study from 1995–2011.

During that time, 17,951 new cancers arose in men and 8,742 in women. Incidence was lower in men than women only for thyroid and gallbladder cancers, and risks were 1.3- to 10.8-times higher in men than women at other anatomic sites. The greatest increased risks in men were seen for esophageal cancer (a 10.8-times higher risk), larynx (a 3.5-times higher risk), gastric cardia (a 3.5-times higher risk), and bladder cancer (a 3.3-times higher risk).

Men had an increased risk of most cancers even after adjusting for a wide range of risk behaviors and carcinogenic exposures. Indeed, differences in risk behaviors and carcinogenic exposures between the sexes only accounted for a modest proportion of the male predominance of most cancers (ranging from 11% for esophageal cancer to 50% for lung cancer).

The findings suggest that biological differences between sexes—such as physiological, immunological, genetic, and other differences—play a major role in the cancer susceptibility of men versus women.

“Our results show that there are differences in cancer incidence that are not explained by environmental exposures alone. This suggests that there are intrinsic biological differences between men and women that affect susceptibility to cancer,” said Dr. Jackson.

An accompanying editorial discusses the study’s findings and notes that a multifaceted approach needs to be in place to address sex disparities in cancer. “Strategically including sex as a biological variable should be enforced along the whole cancer continuum from risk prediction and cancer primary prevention, cancer screening and secondary prevention, to cancer treatment and patient management,” the authors wrote. “Examining and addressing sex disparities in cancer and other diseases is an ongoing quest. Bench to bedside translational studies which effectively transform the existing research findings into clinical practice is a scalable means within easy reach to achieve precision medicine and will mitigate—and may ultimately eradicate—sex disparities in cancer.”

Additional Information

Full Citations:

“Sex disparities in the incidence of 21 cancer types: quantification of the contribution of risk factors.” Sarah S. Jackson, Morgan A. Marks, Hormuzd A. Katki, Michael B. Cook, Noorie Hyun, Neal D. Freedman, Lisa L. Kahle, Philip E. Castle, Barry I. Graubard, and Anil K. Chaturvedi. CANCER; Published Online: August 8, 2022 (DOI: 10.1002/cncr.34390).

Editorial: “Sex disparities in cancer: an ongoing quest.” Jingqin R. Luo and Graham A. Colditz. CANCER; Published Online: August 8, 2022 (DOI: 10.1002/cncr34389).

About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online.

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