Comparative Analysis of Gender-Based Differences in NSCLC between Europe and Asia
DOI:
https://doi.org/10.14738/bjhmr.103.14751Keywords:
Non-Small-Cell-Lung-Cancer, NSCLC, Gender, Sex, Europe, AsiaAbstract
Background: The demographic makeup of lung cancer has shifted over the last decades. Females are more likely to be non-smokers, diagnosed at a younger age, earlier stage, have adenocarcinoma and a family history of cancer. Objectives: the primary objective is to analyze the gender-based differences with regards to clinicopathologic features in Europe and Asia. Methods: This study was based on Oncology Dynamics, using a physician questionnaire. In Q1 2022, IQVIA engaged 1,181 physicians from Europe and 1,402 from Asia. The following items were analyzed: gender, age, smoking status, clinical stage, oncogenic driver status, location of metastases, ECOG, and comorbidities. Results: A total of 18217 cases were analyzed; 7006 (38.5%) were females (F) and 11211 (61.5%) males (M). The percentage of Asian female non-smokers was substantially higher compared to males and European population. Females had more adenocarcinoma and less squamous cell carcinoma cases on both continents. Most patients had metastatic disease at diagnosis. However, in Asia there was a higher proportion of localized disease compared to Europe regardless of sex. The frequency of brain metastases in Asian females was significantly higher (20%) than in Asian males (14%) or the European population (F: 16%, M: 10%). EGFR mutation was the most common oncogenic driver in both genders, but its prevalence was higher in Asian females. Conclusion: This research highlights the differences in cancer staging between Asian and European patients and the importance of gender-based differences suggesting that lung cancer may be increasingly considered a distinct disease in females.
References
Siegel R, Naishadham D, Jemal A. (2013). Cancer statistics, 2013. CA: A Cancer Journal for Clinicians. 2013Jan;63(1):11-30. https://doi.org/10.3322/caac.21166
Singhal S, Miller D, Ramalingam S, Sun SY. (2008). Gene expression profiling of non-small cell lung cancer. Lung Cancer, 60(3):313-24. https://doi.org/10.1016/j.lungcan.2008.03.007
Zarogoulidis K, Zarogoulidis P, Darwiche K, Boutsikou E, Machairiotis N, Tsakiridis K, Katsikogiannis N, Kougioumtzi I, Karapantzos I, Huang H, et al. (2013). Treatment of non-small cell lung cancer (NSCLC). Journal of Thoracic Disease, 5(Suppl 4): S389-96; https://doi.org/10.3978/j.issn.2072-1439.2013.07.10
Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. (2009). Cancer statistics, 2009. CA: A Cancer Journal for Clinicians, 59(4):225-49. https://doi.org/10.3322/caac.20006.
Jemal A, Miller KD, Ma J, et al. (2018). Higher lung cancer incidence in young women than young men in the United States. New England Journal of Medicine, 378:1999–2009. https://doi.org/10.1056/NEJMoa1715907.
Fidler-Benaoudia MM, Torre LA, Bray F, et al. (2020). Lung cancer incidence in young women vs. young men: A systematic analysis in 40 countries. International Journal of Cancer, 147: 811–819. https://doi.org/10.1002/ijc.32809.
Risch HA, Howe GR, Jain M., et al. (1993). Are female smokers at higher risk for lung cancer than male smokers? A case-control analysis by histologic type. American Journal of Epidemiology, 138:281-293. https://doi.org/10.1093/oxfordjournals.aje.a116857.
Zang EA, Wynder EL. (1996). Differences in lung cancer risk between men and women: Examination of the evidence. Journal of the National Cancer Institute, 88:183-192. https://doi.org/10.1093/jnci/88.3-4.183.
Bain C, Feskanich D, Speizer FE, et al. (2004). Lung cancer rates in men and women with comparable histories of smoking. Journal of the National Cancer Institute, 96:826-834. https://doi.org/10.1093/jnci/djh143 151
Bach PB, Kattan MW, Thornquist MD, et al. (2003). Variations in lung cancer risk among smokers. Journal of the National Cancer Institute, 95:470-478. https://doi.org/10.1093/jnci/95.6.470.
US Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress. A Report of the Surgeon General. https://www.hhs.gov/sites/default/files/consequencessmoking-exec-summary.pdf.
Freedman ND, Leitzmann MF, Hollenbeck AR, et al. (2008). Cigarette smoking and subsequent risk of lung cancer in men and women: Analysis of a prospective cohort study. The Lancet Oncology, 9:649-656. https://doi.org/10.1016/S1470-2045(08)70154-2.
Stellman SD, Muscat JE, Thompson S, et al. (1997). Risk of squamous cell carcinoma and adenocarcinoma of the lung in relation to lifetime filter cigarette smoking. Cancer, 80:382-388. https://doi.org/10.1002/(sici)1097-0142(19970801)80:3<382::aid-cncr5>3.0.co;2-u.
Chen KY, Chang Chen KY, Chang CH, Yu CJ, et al. (2005). Distribution according to histologic type and outcome by gender and age group in Taiwanese patients with lung carcinoma. Cancer, 103:2566-2574. https://doi.org/10.1002/cncr.21087.
Fu JB, Kau TY, Severson RK, et al. (2005). Lung cancer in women: Analysis of the national Surveillance, Epidemiology, and End Results database. Chest 127:768-777. https://doi.org/10.1378/chest.127.3.768.
Visbal AL, Williams BA, Nichols FC 3rd, et al. (2004). Gender differences in non-small-cell lung cancer survival: An analysis of 4,618 patients diagnosed between 1997 and 2002. The Annals of Thoracic Surgery, 78:209-215. https://doi.org/10.1016/j.athoracsur.2003.11.021.
An SJ, Chen ZH, Su J, Zhang XC, Zhong WZ, Yang JJ, Zhou Q, Yang XN, Huang L, Guan JL, et al. (2012). Identification of enriched driver gene alterations in subgroups of non-small cell lung cancer patients based on histology and smoking status. PloS One, 7(6):e40109. https://doi.org/10.1371/journal.pone.0040109.
Seo JS, Ju YS, Lee WC, Shin JY, Lee JK, Bleazard T, Lee J, Jung YJ, Kim JO, Shin JY, et al. (2012). The transcriptional landscape and mutational profile of lung adenocarcinoma. Genome Research, 22(11):2109-19. https://doi.org/10.1101/gr.145144.112
Govindan R, Ding L, Griffith M, Subramanian J, Dees ND, Kanchi KL, Maher CA, Fulton R, Fulton L, Wallis J, et al. (2012). Genomic landscape of non-small cell lung cancer in smokers and never-smokers. Cell, 150(6):1121-34. https://doi.org/10.1016/j.cell.2012.08.024
Lung ML, Wong M, Lam WK, et al. (1992). Incidence of ras oncogene activation in lung carcinomas in Hong Kong. Cancer, 70:760-763. https://doi.org/10.1002/1097-0142(19920815)70:4<760::aidcncr2820700407>3.0.co;2-0
Huang SF, Liu HP, Li LH, et al. (2004). High frequency of epidermal growth factor receptor mutations with complex patterns in non-small cell lung cancers related to gefitinib responsiveness in Taiwan. Clinical Cancer Research, 10:8195. https://doi.org/10.1158/1078-0432.CCR-04-1245
The Global Cancer Observatory. (2020). International Agency for Research on Cancer. World Health Organization. Lung cancer fact sheet. https://gco.iarc.fr/today/data/factsheets/cancers/15-Lung-factsheet.pdf.
Donington J. and Y. Colson. (2011). Sex and Gender differences in Non-Small Cell Lung Cancer. Seminars in Thoracic and Cardiovascular Surgery, 23:137-145. https://doi.org/10.1053/j.semtcvs.2011.07.001
Triphuridet N, Henschke C. (2019). Landscape on CT screening for lung cancer in Asia. Lung Cancer (Auckl), 2019 Sep 30;10:107-124. https://doi.org/10.2147/LCTT.S192643 152
Badar F, Meerza F, Khokhar RA, et al. (2006). Characteristics of lung cancer patients - the Shaukat Khanum Memorial experience. Asian Pacific Journal of Cancer Prevention, 7(2):245–248. http://journal.waocp.org/?sid=Entrez:PubMed&id=pmid:16839217&key=2006.7.2.245
Mackay J, Amos A. (2003). Women and tobacco. Respirology, 8: 123-130. https://doi.org/10.1046/j.1440-1843.2003.00464.x
Chen K, Wang PP, Sun B, et al. (2006). Twenty-year secular changes in sex specific lung cancer incidence rates in an urban Chinese population. Lung Cancer, 51(1):13–19. https://doi.org/10.1016/j.lungcan.2005.08.013
Jee SH, Kim IS, Suh I, et al. (1998). Projected mortality from lung cancer in South Korea, 1980–2004. International Journal Epidemiology, 27(3):365–369. https://doi.org/10.1093/ije/27.3.365
Yang L, Parkin DM, Li LD, et al. (2004). Estimation and projection of the national profile of cancer mortality in China: 1991–2005. British Journal of Cancer, 90:2157–2166. https://doi.org/10.1038/sj.bjc.6601813
Guan J, Chen M, Xiao N, et al. (2016). EGFR mutations are associated with higher incidence of distant metastases and smaller tumor size in patients with non-small-cell lung cancer based on PET/CT scan. Medical Oncology, 33:1. https://doi.org/10.1007/s12032-015-0714-8
Hsu F, De Caluwe A, Anderson D, et al. (2016). EGFR mutation status on brain metastases from non-small cell lung cancer. Lung Cancer, 96:101-7. https://doi.org/10.1016/j.lungcan.2016.04.004
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Giorlando, María Aimé, Escorial, Carmen, Gabay, Carolina, Ortega, Elias, Mari, Ettore, Andreasyan, Armen, Schnetter, Laura, Mendoza, Luis

This work is licensed under a Creative Commons Attribution 4.0 International License.