Gender Disparities in NSCLC: A Systematic Review
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2018-01-26
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Abstract
Lung cancer is the second most common malignancy in both men and women. Non-small cell lung cancer (NSCLC) represents 80-85% of cases while the remaining 15 – 20% are small cell lung cancer. Lung cancer incidence in men has steadily decreased since the mid-1980s while it has increased in women. The sex differences in smoking behavior in the last two decades partly account for this incidence pattern. Interestingly, epidemiological evidence suggests that sex alone impacts most facets of lung cancer including the incidence, susceptibility, severity, and molecular basis of the disease; however, there is lack of consensus on the etiology of the gender-based differences as well its magnitude. Therefore, we conducted an evidence-based research of the literature to identify and describe sex-associated characteristics among non-small cell lung cancer patients.
We identified all potentially relevant articles published in English by searching Medline between 1996 and 2016, worldwide. Using a systematic review protocol, all abstracts were reviewed for eligibility, and relevant studies meeting inclusion criteria were retained. We included all studies on NSCLC and its main subtypes for both men and women of age over 45. Pooled data was analyzed using a semi-parametric longitudinal regression model and an ANOVA two-way test. A data-visualization tool was used to demonstrate NSCLC incidence distribution and its sex-based disparities around the world.
Our data found sex-based disparities in NSCLC incidence rates, and a possible increase in female’s risk of acquiring this disease. In addition, data reveal that both race and sex have a significant effect on NSCLC incidence rates and these trends changed with time. Our findings also illustrate that global trends are not always reflective of regional ones. Results also confirms that adenocarcinoma in women is the most commonly diagnosed histology regardless of their race; however, data indicate that Asians are the dominant race to express adenocarcinomas in their lungs.
The objective of this systematic literature review is to more precisely describe this gender disparity among NSCLC patients worldwide and summarize current opinions about the molecular basis for these observations. Our findings serve as a basis to begin to resolve the inherent controversies in the research, and highlight the importance of the inclusion of sex as a risk modifier in the development of screening initiatives and therapies in NSCLC.
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Alsaadoun, N. A. (2018). Gender Disparities in NSCLC: A Systematic Review (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/5461