Selvaraj Rachel C, Cioffi Gino, Waite Kristin A, Jackson Sarah S, Barnholtz-Sloan Jill S
Trans Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.
Department of Statistics, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA.
Cancers (Basel). 2025 Jan 24;17(3):378. doi: 10.3390/cancers17030378.
In cancer, age and sex are often studied individually, but the impact of the intersection of these factors on cancer incidence and survival remains unclear. Using population-level data, we provide an up-to-date analysis of the impact of sex and age on cancer incidence and survival.
Using data from the United States Cancer Statistics public use research database and the Centers for Disease Control and Prevention's National Program of Cancer Registries Survival database, we assessed sex and age differences in the incidence and survival of malignant cancers diagnosed from 2001 to 2020.
Males experienced higher cancer incidence than females in all sites and age groups, excluding 20-29- and 30-39-year-olds. The highest Male-to-female (M:F) age-adjusted incidence rates (IRR) were observed in mesothelioma within ages 80+ (IRR: 5.48; 95% CI: 5.25-5.71; < 0.001), and lowest in endocrine cancer within ages 20-29 years (M:F IRR: 0.20; 95% CI: 0.20-0.21; < 0.001). Among all sites and age groups, excluding 0-9 years, males experienced worse survival than females, particularly within ages 20-29 years (Hazard Ratio (HR): 2.19; 95% CI: 2.15-2.23; < 0.001). Highest M:F HRs were observed in endocrine system cancers within ages 20-29 (HR: 3.52; 95% CI: 3.15-3.94; < 0.001), and lowest among lymphomas within ages 0-9 (HR: 0.74; 95% CI: 0.63-0.87; < 0.001).
Significant age and sex differences in cancer incidence and survival were observed across the US from 2001 to 2020. Males had a higher cancer incidence compared to females, with notable exceptions for younger age groups among certain types, suggesting age may be a critical component in further understanding the biology of sex differences in cancer.
在癌症研究中，年龄和性别通常是分别进行研究的，但这些因素的交叉对癌症发病率和生存率的影响仍不明确。我们利用人群水平的数据，对性别和年龄对癌症发病率和生存率的影响进行了最新分析。
我们使用了来自美国癌症统计公共使用研究数据库和疾病控制与预防中心的国家癌症登记处生存数据库的数据，评估了2001年至2020年期间诊断出的恶性癌症在发病率和生存率方面的性别和年龄差异。
在所有部位和年龄组中，除了20至29岁和30至39岁的人群外，男性的癌症发病率高于女性。在80岁及以上的间皮瘤患者中，观察到最高的男性与女性年龄调整发病率（发病率比值比，IRR）（IRR：5.48；95%置信区间：5.25 - 5.71；P < 0.001），而在20至29岁的内分泌癌患者中最低（男性与女性发病率比值比：0.20；95%置信区间：0.20 - 0.21；P < 0.001）。在所有部位和年龄组中，除了0至9岁的人群外，男性的生存率低于女性，特别是在20至29岁的人群中（风险比（HR）：2.19；95%置信区间：2.15 - 2.23；P < 0.001）。在20至29岁的内分泌系统癌症患者中观察到最高的男性与女性风险比（HR：3.52；95%置信区间：3.15 - 3.94；P < 0.001），而在0至9岁的淋巴瘤患者中最低（HR：0.74；95%置信区间：0.63 - 0.87；P < 0.001）。
2001年至2020年期间，在美国观察到癌症发病率和生存率存在显著的年龄和性别差异。男性的癌症发病率高于女性，但在某些类型的年轻年龄组中有明显例外，这表明年龄可能是进一步理解癌症性别差异生物学机制的关键因素。
