Do women with cancer have better survival as compared to men after adjusting for staging distribution?

Gender aspects in medicine are receiving increasing attention, namely also in oncology. For this reason, we decided to investigate whether for solid cancer sites women have better survival outcome than do men in the population of Tyrol, Austria.

We conducted an observational population-based study in Tyrol. All solid cancer sites excluding non-melanoma skin cancer and sex-specific sites were analysed in total and all specific sites with more than 500 patients in the analysis. By the end of 2006, follow-up was ended. We applied a relative excess risk model, thus correcting for differences in life expectancy between women and men.

For all cancer sites combined, after adjusting for case mix, women had a relative excess risk of 0.95 (95% CI 0.91-0.99). For the following sites our analysis resulted in a relative excess risk statistically different from 1, namely for women as compared to men: head and neck without larynx 0.72 (95% CI 0.56-0.93), stomach 0.86 (95% CI 0.75-0.97) and lung 0.82 (95% CI 0.75-0.90).

In a healthcare system with free access to diagnostics and therapy, after adjusting for staging distribution female cancer patients have a lesser excess mortality risk than do men for lung, stomach and head and neck cancer and also for all cancer sites combined after adjusting for case mix.