Abstract
Abstract
Background
Colorectal cancer (CRC) is among the three most common incident cancers and causes of cancer death in Switzerland for both men and women. To promote aspects of gender medicine, we examined differences in treatment decision and survival by sex in CRC patients diagnosed 2000 and 2001 in the canton of Zurich, Switzerland.
Methods
Characteristics assessed of 1076 CRC patients were sex, tumor subsite, age at diagnosis, tumor stage, primary treatment option and comorbidity rated by the Charlson Comorbidity Index (CCI). Missing data for stage and comorbidities were completed using multivariate imputation by chained equations. We estimated the probability of receiving surgery versus another primary treatment using multivariable binomial logistic regression models. Univariable and multivariable Cox proportional hazards regression models were used for survival analysis.
Results
Females were older at diagnosis and had less comorbidities than men. There was no difference with respect to treatment decisions between men and women. The probability of receiving a primary treatment other than surgery was nearly twice as high in patients with the highest comorbidity index, CCI 2+, compared with patients without comorbidities. This effect was significantly stronger in women than in men (p-interaction = 0.010). Survival decreased with higher CCI, tumor stage and age in all CRC patients. Sex had no impact on survival.
Conclusion
The probability of receiving any primary treatment and survival were independent of sex. However, female CRC patients with the highest CCI appeared more likely to receive other therapy than surgery compared to their male counterparts.
Funder
Alfred und Anneliese Sutter-Stöttner Stiftung
Krebsliga Zürich
Universität Zürich
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Oncology,General Medicine
Reference61 articles.
1. Benedix F, Kube R, Meyer F, Schmidt U, Gastinger I, Lippert H (2010) Comparison of 17,641 patients with right- and left-sided colon cancer: differences in epidemiology, perioperative course, histology, and survival. Dis Colon Rectum 53:57–64. https://doi.org/10.1007/DCR.0b013e3181c703a4
2. Boakye D, Rillmann B, Walter V, Jansen L, Hoffmeister M, Brenner H (2018) Impact of comorbidity and frailty on prognosis in colorectal cancer patients: a systematic review and meta-analysis. Cancer Treat Rev 64:30–39. https://doi.org/10.1016/j.ctrv.2018.02.003
3. Bodner TE (2008) What Improves with Increased Missing Data Imputations? Struct Equ Model Multidiscipl J 15:651–675. https://doi.org/10.1080/10705510802339072
4. Bordoni A, Lorez M, Bouchardy C, Konzelmann I, Clough-Gorr K, and the NICER Working Group (2012) Trends in Colorectal Cancer Survival in Switzerland. Schweizerische Arbeitsgemeinschaft für klinische Krebsforschung SAKK, Schweizer Krebsbulletin, vol Nr. 1/2012
5. Brenner H, Hoffmeister M, Arndt V, Haug U (2007) Gender differences in colorectal cancer: implications for age at initiation of screening. Br J Cancer 96:828–831. https://doi.org/10.1038/sj.bjc.6603628
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献