Background
Despite a global decline in lung cancer incidence, females exhibit heightened susceptibility compared to males, indicating distinct disease mechanisms and risk factors between the sexes. This study aimed to explore gender-related prognostic differences in inoperable lung cancer within resource-limited environments.
Methods
Recruiting 1868 recently diagnosed inoperable lung cancer patients at the National Institute of Cancer Research & Hospital in Dhaka, Bangladesh, between 2018 and 2019, demographic and clinical data were extracted from medical records. Survival estimates, derived through the Kaplan-Meier method, were compared across categories using the log-rank test. Hazard ratios and 95% confidence intervals for treatment options were determined via multivariable Cox proportional hazard regression models.
Results
Female patients (55.3±12.9) were younger on average than males (60.4±10.3) (p<0.001). Female smokers had a higher lung cancer risk than males [HR-1.88 (95% CI; 1.44, 2.46)]. Predictors of poor survival in men aged 60 years and older included being underweight, having no formal education, and comorbidities compared to female. Females exhibited a significantly higher comorbidity count (p<0.001). Adenocarcinoma was the predominant histological type in women (46.3%) and squamous cell carcinoma in men (43.2%). Survival rates for female adenocarcinoma patients surpassed those for males across various factors [HR-0.64 (95% CI;0.44, 0.91)], while the reverse was true for squamous cell carcinoma patients [HR-1.31 (95% CI;1.04, 1.63)].
Conclusion
Female lung cancer patients, distinctively, are more likely to be younger nonsmokers with adenocarcinoma, showing better prognosis with standard treatments, while smoking and being overweight are associated with poorer survival in females, with age not emerging as a significant factor.