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Sarasqueta C, Zunzunegui MV, Enríquez Navascues JM, Querejeta A, Placer C, Perales A, Gonzalez N, Aguirre U, Baré M, Escobar A, Quintana JM. Gender differences in stage at diagnosis and preoperative radiotherapy in patients with rectal cancer. BMC Cancer 2020; 20:759. [PMID: 32795358 PMCID: PMC7427942 DOI: 10.1186/s12885-020-07195-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/19/2020] [Indexed: 02/07/2023] Open
Abstract
Background Few studies have examined gender differences in the clinical management of rectal cancer. We examine differences in stage at diagnosis and preoperative radiotherapy in rectal cancer patients. Methods A prospective cohort study was conducted in 22 hospitals in Spain including 770 patients undergoing surgery for rectal cancer. Study outcomes were disseminated disease at diagnosis and receiving preoperative radiotherapy. Age, comorbidity, referral from a screening program, diagnostic delay, distance from the anal verge, and tumor depth were considered as factors that might explain gender differences in these outcomes. Results Women were more likely to be diagnosed with disseminated disease among those referred from screening (odds ratio, confidence interval 95% (OR, CI = 7.2, 0.9–55.8) and among those with a diagnostic delay greater than 3 months (OR, CI = 5.1, 1.2–21.6). Women were less likely to receive preoperative radiotherapy if they were younger than 65 years of age (OR, CI = 0.6, 0.3–1.0) and if their tumors were cT3 or cT4 (OR, CI = 0.5, 0.4–0.7). Conclusions The gender-specific sensitivity of rectal cancer screening tests, gender differences in referrals and clinical reasons for not prescribing preoperative radiotherapy in women should be further examined. If these gender differences are not clinically justifiable, their elimination might enhance survival.
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Affiliation(s)
- Cristina Sarasqueta
- Biodonostia Health Research Institute - Donostia University Hospital, Paseo Dr. Beguiristain s/n (Gipuzkoa), 20014, Donostia-San Sebastián, Spain. .,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.
| | - Mª Victoria Zunzunegui
- Professeure honoraire. École de santé publique (ESPUM) Departement de médecine sociale et préventive, Université de Montréal, Pavillon 7101, salle 3111 7101, Avenue du Parc Montréal, Québec, H3N 1X9, Canada
| | - José María Enríquez Navascues
- Department of General and Digestive Surgery, Donostia University Hospital, Paseo Dr. Beguiristain 109 (Gipuzkoa), 20014, Donostia-San Sebastián, Spain
| | - Arrate Querejeta
- Radiotherapic Oncology, Donostia University Hospital, Paseo Dr. Beguiristain 109 (Gipuzkoa), 20014, Donostia-San Sebastián, Spain
| | - Carlos Placer
- Department of General and Digestive Surgery, Donostia University Hospital, Paseo Dr. Beguiristain 109 (Gipuzkoa), 20014, Donostia-San Sebastián, Spain
| | - Amaia Perales
- Biodonostia Health Research Institute, Paseo Dr. Beguiristain s/n (Gipuzkoa), 20014, Donostia-San Sebastián, Spain
| | - Nerea Gonzalez
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.,Research Unit, Galdakao-Usansolo Hospital, Labeaga Auzoa, 48960, Galdakao, Bizkaia, Spain
| | - Urko Aguirre
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.,Research Unit, Galdakao-Usansolo Hospital, Labeaga Auzoa, 48960, Galdakao, Bizkaia, Spain
| | - Marisa Baré
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.,Clinical Epidemiology and Cancer Screening, Corporació Sanitaria Parc Taulí, Parc Taulí 1, 08208 Sabadell, Barcelona, Spain
| | - Antonio Escobar
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.,Research Unit, Hospital Basurto, Avda Montevideo, 18, 48013, Bilbao, Bizkaia, Spain
| | - José María Quintana
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Bizkaia, Spain.,Research Unit, Galdakao-Usansolo Hospital, Labeaga Auzoa, 48960, Galdakao, Bizkaia, Spain
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