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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 and in the canton of Zurich, Switzerland.
Characteristics assessed of 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. Females were older at diagnosis and had less comorbidities than men. There was no difference with respect to treatment decisions between men and women. Sex had no impact on survival. 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.
About cases of colorectal cancer CRC are diagnosed in Switzerland every year, making it one of the three most common incident cancers, which is in line with the world cancer incidence report Forman et al. Despite a decreasing mortality for both men and women, as recently reported for Switzerland Bordoni et al. Investigations into differences of biological, behavioral and environmental factors between men and women and their impact on the manifestation, mechanism, treatment and outcome of disease is the task of gender medicine.
