Women ‘21% less likely’ to die from cancer: Study

Researchers have called for biological sex to be used as a prognostic factor in cancer care after a study found women are significantly more likely to survive cancer than men in US treatment trials.
 
The study, led by researchers at Adelaide University and published in the Journal of the National Cancer Institute covered a cohort of 20,806 participants with advanced-stage cancers.
 
It used data from 39 clinical trials from 2011–21 used to evaluate treatments which were approved by the US Food and Drug Administration.
 
Researchers found a 21% lower risk of death for female participants, who also had a 16% lower risk of disease progression.
 
However, women were also found to have a 12% higher risk of severe side effects from treatments.
 
The study found the associations were ‘largely consistent’ across 11 advanced solid tumour types, with lead author Dr Natansh Modi saying the work gives some of the clearest evidence yet about the role of biological sex as a predictor of cancer care outcomes.
 
‘Sex is a fundamental biological factor that influences immune function, drug metabolism, body composition and tumour biology,’ he said.
 
‘Yet despite longstanding recommendations from regulatory and funding bodies to report outcomes by sex, it is still treated as an afterthought in many trials and is rarely factored into baseline risk or used to personalise treatment decisions.’
 
Associate Professor Magdalena Simonis, a Melbourne GP with interests in women’s and men’s health, as well as an honorary primary care researcher with the University of Melbourne, noted the ‘really significant’ disparity in the results.
 
‘It’s really returning to that same conversation that we’ve uncovered, that there are sex differences in health needs and health outcomes,’ she told newsGP.
 
‘What it also means here is that when we talk about gender disparity, then men are also being disadvantaged through the lack of research that we have around sex-based differences.’
 
However, she believes it remains ‘a bit premature’ for biological sex to be used as a prognostic factor in oncology.
 
‘We need to have a sense of open-mindedness, and acknowledge the gap in research, the need for funding of sex-based research, sex-differentiated research, and sex-differentiated clinical trials,’ she said.
 
‘It’s a positive thing to see that researchers are thinking about this and investigating sex-based differences.’
 
Previous analyses have reported higher cancer survival probabilities for women, although findings have varied between studies and cancer types.
 
The Adelaide University researchers also acknowledged uncertainty about their results for some cancer types. Confidence intervals in their analysis included the possibility that a better overall survival rate for female patients was not statistically significant in five cancer types.
 
‘Overall, these findings suggest that sex is a prognostic factor for cancer survival, although observed variability across trials (and tumour types) warrants cautious interpretation at the individual level,’ they wrote.
 
‘Importantly, our analyses address baseline prognosis rather than sex-specific treatment effects, which are the usual focus of subgroup analyses.
 
‘The consistently poorer prognosis among men underscores the need to investigate biological, behavioural, sociological and treatment-related drivers of this disparity.’
 
Associate Professor Simonis agrees that the field of research is one to watch.
 
‘It’s very interesting and it should make a lot of researchers very curious to further validate these findings,’ she said.
 
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