In this E-Learning module, the author provides definitions of sex, a biological variable, and gender, that refers to the socially constructed characteristics of women, men, girls and boys, and elaborates in depth on the influence of sex and gender on cancer risk and outcome. Globally, men have higher cancer incidence and mortality rates, and the author explains this from both a historical and current point of view.
The author describes sex and gender related differences in survival, tumour biology and diagnosis, using the example of melanoma (better survival in women independently of stage and age), lung cancer as an example of sex-related differences in tumour biology (e.g. molecular subtype), and bladder cancer, as an example of gender-related differences in diagnosis, highlighting diagnostic delays in women.
In addition, several analyses of registry data are presented which show sex and gender differences in treatment allocation, with women receiving less often treatment with curative intent (e.g. for gastro-oesophageal cancer) with detrimental effects on the outcome.
There is also increasing interest in differences in treatment toxicity between men and women, with women experiencing higher toxicity risk for various types of treatments. The author explains a range of factors which contribute to this increased toxicity risk in women.
The author, who is a driving force of the ESMO initiative on gender medicine in oncology, advocates that more research is needed to move the field of sex- and gender-related aspects in oncology forward.
