Sex-Based Differences in Lung Cancer Incidence: A Retrospective Analysis of Two Large US-Based Cancer Databases.

Area of Science:

• Oncology
• Epidemiology
• Public Health

Background:

• Non-small cell lung cancer (NSCLC) incidence is rising relatively more in females than males.
• Existing data on sex-based incidence trends in NSCLC across diverse populations remain limited.
• High-risk populations require specific investigation to understand lung cancer risk factors.

Purpose of the Study:

• To retrospectively examine sex-based differences in lung cancer incidence.
• To analyze NSCLC risk in high-risk clinical cohorts.
• To identify potential sex-specific disparities in lung cancer development.

Main Methods:

• Analysis of lung cancer incidence in the National Lung Screening Trial (NLST) cohort (n=37,627) with >40 pack-year smoking history.
• Investigation of second primary NSCLC incidence in the Surveillance, Epidemiology, and End Results (SEER) database (n=19,327) for patients with prior stage I lung cancer.
• Application of univariate and multivariable time-to-event analyses to assess the relationship between sex and lung cancer incidence.

Main Results:

• Females demonstrated a higher risk of primary NSCLC in the NLST cohort (HR=1.11, p=0.035) after adjusting for age and smoking history.
• The SEER cohort analysis revealed an increased risk of second primary lung cancer in females (HR=1.138, p=0.021) after adjusting for clinical factors.
• Both cohorts indicated a modestly higher lung cancer incidence in females compared to males within high-risk groups.

Conclusions:

• Females exhibit a modestly elevated incidence of lung cancer compared to males in high-risk populations.
• These findings highlight the need for further investigation into the biological mechanisms underlying sex-specific differences in lung cancer.
• Understanding these disparities is crucial for targeted prevention and treatment strategies in NSCLC.