Men have a worse prognosis after diagnosed with cancer

Men, compared to women, are at a higher risk of developing 34 of 39 cancer types affecting both sexes and have a poorer prognosis in 27 of 39. This was shown in the doctoral thesis Sex differences in cancer risk and survival by Cecilia Radkiewicz, medical oncologist and researcher at the Department of Medical Epidemiology and Biostatistics.

Cecilia Radkiewicz, photo Gunilla Sonnebring
Cecilia Radkiewicz Photo: Gunilla Sonnebring

“Our findings suggest that men in general seek medical attention at a later disease stage resulting in poorer cancer prognosis. Community measures to increase the awareness of  cancer alarm symptoms as well as sanctioning of healthcare seeking behavior should be raised in general and in men in particular” says Cecilia Radkiewicz.

Her thesis shows that a fair proportion of the excess cancer risk in men compared to women can be explained by a taller body stature. A larger body consists of more cells resulting in a higher number of cumulative cell divisions increasing the risk of random errors during DNA-replication and a higher lifetime risk of developing a malignancy.

Furthermore, Dr Radkiewicz examined sex differences in survival in two common malignancies: non-small cell lung cancer (NSCLC), for which it is well-known that women have a superior prognosis; and urinary bladder cancer, one of few tumours for which women have a poorer prognosis, compared to men.

Women with NSCLC had a consistently higher lung cancer specific survival independent of stage as well as a wide range of clinical and pathological factors known to affect prognosis. Nor did the researchers find any indications of unequal clinical management of men and women diagnosed with NSCLC. The rationale behind this discrepancy remains unclear.

The inferior survival of women with urinary bladder cancer was restricted to patients diagnosed with locally advanced, but not yet metastasized tumours,. This patient group is potentially cured after surgical resection, with or without preoperative chemotherapy.

“Our results suggest discrepancies in the clinical management, including surgical procedure, between men and women with locally advanced urinary bladder cancer. We are planning to investigate this more closely,” she says.

Text: Sara Nilsson, first published in Medicinsk Vetenskap nr 3 2020