Sex differences in esophageal cancer overall and by histological subtype

Abstract

Esophageal cancer is the seventh most common type of cancer in the world, the sixth leading cause of cancer-related death and its incidence is expected to rise 140% in the world in a period of 10 years until 2025. The overall incidence is higher in males, while data about prognosis and survival are not well established yet. The goal of this study was to carry out a comprehensive analysis of differences between sexes and other covariates in patients diagnosed with primary esophageal cancer. Data from 2005 to 2020 were obtained from the University Hospitals (UH) Seidman Cancer Center and from 2005 to 2018 from SEER. Patients were categorized according to histological subtype and divided according to sex. Pearson Chi-square test was used to compare variables of interest by sex and the influence of sex on survival was assessed by Kaplan Meier, log rank tests and Cox proportional hazards regression models. A total of 1205 patients were used for analysis. Sex differences in all types were found for age at diagnosis, histology, smoking status and prescriptions of NSAIDs and in SCC for age at diagnosis and alcoholism. Survival analysis didn’t showed differences between males and females on univariable and multivariable models. Males have a higher incidence of Esophageal Cancer and its two main subtypes but none of the comprehensive set of variables analyzed showed to be strongly or unique correlated with this sex difference in incidence nor are they associated with a sex difference in survival.

Dietary acid load and esophageal cancer risk: A case‐control study

“…5 However, different survival analysis models have not shown differences between men and women. 4 Recent studies suggested that almost 90% of cases occur in individuals aged 55 years or older. 1,2 The two most common histological cancer types include esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), 6 which usually occur in either the proximal (ESCC) or distal (EAC) esophagus, respectively.…”

“…It has the potential to metastasize at early stages and is characterized by disproportionally high mortality rates and a poor prognosis 2,3 . EC occurs more often in males than in females and becomes more common with older age 2,4 . Furthermore, among American inhabitants, men have around four‐fold higher death rates 5 .…”

“…Furthermore, among American inhabitants, men have around four‐fold higher death rates 5 . However, different survival analysis models have not shown differences between men and women 4 . Recent studies suggested that almost 90% of cases occur in individuals aged 55 years or older 1,2 …”

“… 2 , 3 EC occurs more often in males than in females and becomes more common with older age. 2 , 4 Furthermore, among American inhabitants, men have around four‐fold higher death rates. 5 However, different survival analysis models have not shown differences between men and women.…”

“… 5 However, different survival analysis models have not shown differences between men and women. 4 Recent studies suggested that almost 90% of cases occur in individuals aged 55 years or older. 1 , 2 …”