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Dijksterhuis WPM, Kalff MC, Wagner AD, et al. Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: A Population-Based Study. J Natl Cancer Inst. 2021;113(11):1551-1560doi: 10.1093/jnci/djab075.
Dijksterhuis, W. P. M., Kalff, M. C., Wagner, A. D., Verhoeven, R. H. A., Lemmens, V. E. P. P., van Oijen, M. G. H., Gisbertz, S. S., van Berge Henegouwen, M. I., & van Laarhoven, H. W. M. (2021). Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: A Population-Based Study. Journal of the National Cancer Institute, 113(11), 1551-1560. https://doi.org/10.1093/jnci/djab075
Dijksterhuis, Willemieke P M, et al. "Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: A Population-Based Study." Journal of the National Cancer Institute vol. 113,11 (2021): 1551-1560. doi: https://doi.org/10.1093/jnci/djab075
Dijksterhuis WPM, Kalff MC, Wagner AD, Verhoeven RHA, Lemmens VEPP, van Oijen MGH, Gisbertz SS, van Berge Henegouwen MI, van Laarhoven HWM. Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: A Population-Based Study. J Natl Cancer Inst. 2021 Nov 02;113(11):1551-1560. doi: 10.1093/jnci/djab075. PMID: 33837791; PMCID: PMC8562959.
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J Natl Cancer Inst. 2021 Nov 02;113(11):1551-1560. doi: 10.1093/jnci/djab075.

Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: A Population-Based Study.

Journal of the National Cancer Institute

Willemieke P M Dijksterhuis, Marianne C Kalff, Anna D Wagner, Rob H A Verhoeven, Valery E P P Lemmens, Martijn G H van Oijen, Suzanne S Gisbertz, Mark I van Berge Henegouwen, Hanneke W M van Laarhoven

Affiliations

  1. Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, the Netherlands.
  2. Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
  3. Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Amsterdam, the Netherlands.
  4. Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
  5. Department of Public Health, Erasmus MC, Erasmus University, Rotterdam, the Netherlands.

PMID: 33837791 PMCID: PMC8562959 DOI: 10.1093/jnci/djab075

Abstract

BACKGROUND: Biological sex and gender have been reported to affect incidence and overall survival (OS) of curatively treated gastroesophageal cancer. The aim of this study was to compare palliative treatment allocation and OS between women and men with advanced gastroesophageal cancer.

METHODS: Patients with an unresectable or metastatic esophageal (including cardia) adenocarcinoma (EAC) or squamous cell carcinoma (ESCC) or gastric adenocarcinoma (GAC) diagnosed in 2015-2018 were identified in the Netherlands Cancer Registry. Treatment allocation was compared using χ2 tests and multivariable logistic regression analyses, and OS using the Kaplan-Meier method with log-rank test and Cox proportional hazards analysis. All statistical tests were 2-sided.

RESULTS: Of patients with EAC (n = 3077), ESCC (n = 794), and GAC (n = 1836), 18.0%, 39.4%, and 39.1% were women, respectively. Women less often received systemic treatment compared with men for EAC (42.7% vs 47.4%, P = .045) and GAC (33.8% vs 38.8%, P = .03) but not for ESCC (33.2% vs 39.5%, P = .07). Women had a lower probability of receiving systemic treatment for GAC in multivariable analyses (odds ratio [OR] = 0.79, 95% confidence interval [CI] = 0.62 to 1.00) but not for EAC (OR = 0.86, 95% CI = 0.69 to 1.06) and ESCC (OR = 0.81, 95% CI = 0.57 to 1.14). Median OS was lower in women with EAC (4.4 vs 5.2 months, P = .04) but did not differ after adjustment for patient and tumor characteristics and systemic treatment administration.

CONCLUSIONS: We observed statistically significant and clinically relevant gender differences in systemic treatment administration and OS in advanced gastroesophageal cancer. Causes of these disparities may be sex based (ie, related to tumor biology) as well as gender based (eg, related to differences in treatment choices).

© The Author(s) 2021. Published by Oxford University Press.

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