Sex- and gender-specific disparities in colorectal cancer risk

Abstract

Colorectal cancer is one of the most common causes of cancer morbidity both in men and in women. However, females over 65 years old show higher mortality and lower 5-year survival rate of colorectal cancer compared to their age-matched male counterparts. The objective of this review is to suggest gender-based innovations to improve colorectal cancer outcomes in females. Women have a higher risk of developing right-sided (proximal) colon cancer than men, which is associated with more aggressive form of neoplasia compared to left-sided (distal) colon cancer. Despite differences in tumor location between women and men, most of scientific researchers do not consider sex specificity for study design and interpretation. Also, colorectal cancer screening guidelines do not distinguish females from male, which may explain the higher frequency of more advanced neoplasia when tumors are first detected and false negative results in colonoscopy in females. Moreover, socio-cultural barriers within females are present to delay screening and diagnosis. Few studies, among studies that included both men and women, have reported sex-specific estimates of dietary risk factors which are crucial to establish cancer prevention guidelines despite sex- and gender-associated differences in nutrient metabolism and dietary practices. Furthermore, anti-cancer drug use for colorectal cancer treatment can cause toxicity to the reproductive system, and gender-specific recurrence and survival rates are reported. Therefore, by understanding sex- and gender-related biological and socio-cultural differences in colorectal cancer risk, gender-specific strategies for screening, treatment and prevention protocols can be established to reduce the mortality and improve the quality of life.

Oncological treatment and outcome of colorectal cancer in Greenland

“…Statistics from Korea and Japan have indicated that women over 65 years show a higher mortality and lower 5-year survival compared to their age-matched male counterparts [33,34]. Further, a review from 2015 covering gender impact on CRC suggests that both genetic factors, dietary habits and socio-cultural environmental factors may attribute to a gender-specific disparity [35]. A review from 2012 reports that women are more prone to right-sided colon cancer than men, associated with a poorer prognosis [36].…”

A Single Centre Retrospective Review of Colorectal Cancer in Trinidad over a Three Year Period

“…It has been found in previous studies that the incidence of CRC was more common in females than males, in older persons (more than 65 years) [7,8]. The average age of persons in this study was 65.…”

“…There are gender differences in CRC. The incidence of CRC is higher in females than in males, when considering persons older and 65 years [7,8]. The 5-year survival rate for colorectal cancer in females, over the age of 70, is higher than that for males [7].…”

“…The incidence of CRC is higher in females than in males, when considering persons older and 65 years [7,8]. The 5-year survival rate for colorectal cancer in females, over the age of 70, is higher than that for males [7].In a review of the literature it was found that patients with right-sided CRC were more likely to be female, have poorly differentiated tumors and present with larger tumors [9]. A German study found that patients with right-sided colon cancer also tended to present with vague symptoms and this was associated with later presentation and more advanced stage at presentation [10].…”

GIANT: an online resource for comprehensive survival analysis in pan-cancer from The Cancer Genome Atlas (Preprint)

“…For instance, we did survival analysis by cancer type (n=228, cancer type: colorectal adenocarcinoma, cancer type The site and subtype of cancer, and the prognosis of patients depend on gender, stage, race etc [12][13][14][15][16][17]. For these reasons, subgroup analysis is required to identify stage-and genderspecific prognostic genes.…”