Gender differences in stage at diagnosis and preoperative radiotherapy in patients with rectal cancer

Cristina Sarasqueta,Marisa Baré,Nerea González ,Maria-Victoria Zunzunégui ,Carlos Placer,Amaia Perales,Antonio Escobar,Jose María Enríquez Navascués ,A Querejeta ,Urko Aguirre,José M Quintana

doi:10.1186/s12885-020-07195-4

Abstract

BackgroundFew studies have examined gender differences in the clinical management of rectal cancer. We examine differences in stage at diagnosis and preoperative radiotherapy in rectal cancer patients.MethodsA prospective cohort study was conducted in 22 hospitals in Spain including 770 patients undergoing surgery for rectal cancer. Study outcomes were disseminated disease at diagnosis and receiving preoperative radiotherapy. Age, comorbidity, referral from a screening program, diagnostic delay, distance from the anal verge, and tumor depth were considered as factors that might explain gender differences in these outcomes.ResultsWomen were more likely to be diagnosed with disseminated disease among those referred from screening (odds ratio, confidence interval 95% (OR, CI = 7.2, 0.9–55.8) and among those with a diagnostic delay greater than 3 months (OR, CI = 5.1, 1.2–21.6). Women were less likely to receive preoperative radiotherapy if they were younger than 65 years of age (OR, CI = 0.6, 0.3–1.0) and if their tumors were cT3 or cT4 (OR, CI = 0.5, 0.4–0.7).ConclusionsThe gender-specific sensitivity of rectal cancer screening tests, gender differences in referrals and clinical reasons for not prescribing preoperative radiotherapy in women should be further examined. If these gender differences are not clinically justifiable, their elimination might enhance survival.

Highlights

Few studies have examined gender differences in the clinical management of rectal cancer
We sought to describe the magnitude of any gender differences, and to examine whether they vary by age, or clinical or tumor characteristics
No significant differences between men and women were found in age, percentage diagnosed through screening or tumor distance from the anal verge

Summary

Introduction

Few studies have examined gender differences in the clinical management of rectal cancer. We examine differences in stage at diagnosis and preoperative radiotherapy in rectal cancer patients. Some studies have reported that women have more advanced stages at diagnosis in colorectal cancer [1,2,3,4,5,6]. Five studies have reported that women are less likely to receive preoperative radiotherapy [17,18,19,20,21], but how a patient’s gender influences clinical management of rectal. The aforementioned findings prompt us to question under which circumstances the clinical management of rectal cancer vary between men and women. The aim of this study was to investigate potential differences in stage at diagnosis and use of preoperative radiotherapy between men and women with rectal cancer. We sought to describe the magnitude of any gender differences, and to examine whether they vary by age, or clinical or tumor characteristics

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