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Men in the United States are more likely than women to be diagnosed with many types of cancer at regional or distant stages, according to a new study that analyzed more than 2.4 million cancer cases between 2015 and 2022.
The study, published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, examined 2,401,772 cancer cases recorded in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 21 database.
Researchers assessed 30 different nonreproductive solid tumor types and compared cancer stage at diagnosis between men and women.
Cancer stage is widely regarded as one of the most important indicators of how a patient is likely to fare after diagnosis.
Localized cancers remain at their site of origin, while regional cancers have spread to nearby lymph nodes and distant cancers have spread to other organs or distant lymph nodes. The researchers classified regional and distant cancers as later-stage disease.
Lead author Beth Maclin, PhD, MPH, a postdoctoral fellow in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute, said understanding differences in diagnosis stages could help explain broader disparities in cancer outcomes.
She explained that cancer stage at diagnosis is an important prognostic factor and that, in general, the more advanced a cancer’s stage at diagnosis, the worse the patient’s prognosis tends to be.
“We know that, overall, males are more likely than females to die from many types of cancer. We also know that cancer stage at diagnosis is a key predictor of cancer survival. It is important to better understand how stage may differ between sexes as a way to explain sex differences in cancer mortality and to identify potential intervention points to improve cancer survival for everyone,” she said.
After adjusting for differences in age and year of diagnosis, the researchers found that men were significantly more likely than women to receive a regional-stage diagnosis rather than a localized-stage diagnosis for 16 cancer types.
Some of the largest differences were observed in cancers of the salivary gland, oropharyngeal, thyroid and stomach.
Men were 151 percent more likely than women to receive a regional-stage diagnosis for tongue cancer, 93 percent more likely for salivary gland cancer, 80 percent more likely for oropharyngeal cancer, 74 percent more likely for thyroid cancer and 67 percent more likely for stomach cancer.
The researchers also found that men were significantly more likely than women to be diagnosed at a distant stage rather than a localized stage for 17 cancer sites.
Maclin said several factors could help explain why men were more likely to receive later-stage cancer diagnoses, including differences in screening participation, healthcare-seeking behavior and how cancer symptoms are assessed by clinicians.
She noted that women tend to visit doctors more often, which may create more opportunities to detect cancer earlier.
“There is also the possibility that the way clinicians perceive cancer symptoms in males and females differ, leading to different types of diagnostic tests or treatment plans, which can either hasten or delay cancer diagnosis,” she said.
The findings may provide insight into discrepancies between men and women in cancer outcomes, according to the researchers.
The study did not include sex-specific cancers and focused exclusively on nonreproductive solid organ tumors. Researchers said their analysis was designed to identify associations between sex and disease stage at diagnosis across a broad range of cancers.
The researchers also identified a few exceptions where men were less likely than women to receive later-stage diagnoses.
Men with laryngeal and bladder cancer were less likely to be diagnosed at a regional stage rather than a localized stage, while men with bladder, anal and liver cancer were less likely than women to be diagnosed after the disease had spread to distant parts of the body.
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