Gender influences colon cancer diagnosis, outcome in Ohio women

In Ohio, women with colon cancer presented with more advanced disease and had a worse prognosis than men, according to researchers in Cincinnati. In addition, female patients were older than male patients at the time of diagnosis and were more likely to have right-sided colon cancer, which is difficult to assess endoscopically, according to the study in the Journal of Women's Health.

Dr. Scott Woods and colleagues from the Bethesda Family Medicine Residency Program and Good Samaritan Hospital retrospectively evaluated data from 27,041 patients who were diagnosed with adenocarcinoma of the colon between 1996 and 2001. Of these patients tracked by the State of Ohio Tumor Registry, 51% (13,807) were women.

Woods' group expanded on a previous study in which they investigated gender and colon cancer stage in one region of Ohio (versus the entire state). They found that female gender was a predictor of later-stage disease (Journal of Women's Health, July-August 2005, Vol. 14:6, pp. 502-506).

In the latest study, the researchers collected data on gender and cancer stage, age, location of the colon cancer, and race, with the latter eventually ruled out as a confounding variable.

According to the results, women were less likely to have carcinoma in situ when compared with men (odds ratio [OR] = 0.82, 95% CI). In addition, women showed significantly more regional disease (OR = 1.11, 95% CI), as well as a slight increase in distant disease (OR = 0.89, 95% CI). Finally, women were less likely to have a good prognostic stage (OR = 0.89, 95%) and more likely to have a bad prognostic stage (OR = 1.12, 95% CI).

"Given the discrepancy between men and women with respect to the stage at which colorectal cancer is identified, clinicians and researchers must consider two areas: prevention and detection," Woods' group wrote (Journal of Women's Health, September 2006, Vol. 15:7, pp. 877-881).

In terms of detection, previous studies have argued that flexible sigmoidoscopy is inadequate in women, the authors stated. In an e-mail interview with AuntMinnie.com, Woods -- who is the associate program director in epidemiology and recruitment at Bethesda -- said that women may be better served by colonoscopy, because of its ability to spot right-sided lesions, and/or virtual colonoscopy, which has been shown to have greater patient compliance.

Another major barrier that may stop women from undergoing colon cancer screening is their doctor's emphasis on breast and cervical cancer screening, especially if their primary care physician is a gynecologist, the authors noted. Future studies will have to take a closer look at the various factors that influence later detection in women, they added.

A recent study out of Poland also looked at gender differences in colon cancer. This group from the Maria Sklodowska-Curie Memorial Cancer Center in Warsaw found that during colorectal cancer screening with colonoscopy, advanced neoplasia was more often detected in men than in women (New England Journal of Medicine, November 2, 2006, Vol. 355:18, pp. 1863-1872).

Woods pointed out that the Polish authors considered high-grade neoplasia as a precancerous or early cancer lesion. "They may be dysplastic but they are small and all (are detected early)," he explained, supporting the theory that men were more likely to be diagnosed with colon cancer at an earlier stage.

By Shalmali Pal
AuntMinnie.com staff writer
November 10, 2006

Related Reading

Advanced colorectal neoplasia more often detected in men, November 2, 2006

Alcohol, tobacco, and male gender up risk of earlier onset colorectal cancer, March 28, 2006

Copyright © 2006 AuntMinnie.com

Page 1 of 660
Next Page