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Gender differences in stage at diagnosis and preoperative radiotherapy in patients with rectal cancer

2020; BioMed Central; Volume: 20; Issue: 1 Linguagem: Inglês

10.1186/s12885-020-07195-4

1471-2407

Cristina Sarasqueta, Marı́a Victoria Zunzunegui, José M. Enríquez–Navascués, Arrate Querejeta, Carlos Placer, Amaia Perales, Nerea González, Urko Aguirre, Marisa Baré, Antonio Escobar, José M. Quintana, José M. Quintana, Marisa Baré Mañas, Maximino Redondo, Eduardo Briones Pérez de la Blanca, Nerea Fernández de Larrea Baz, Cristina Sarasqueta Eizaguirre, Antonio Escobar Martínez, Francisco Rivas-Ruíz, María Morales‐Suárez‐Varela, Juan Antonio Blasco‐Amaro, Isabel del Cura-González, Inmaculada Aróstegui, Amaia Bilbao González, Nerea González Hernández, Susana García‐Gutiérrez, Iratxe Lafuente Guerrero, Urko Aguirre, Miren Orive, Josune Martin Corral, Ane Antón-Ladislao, Núria Torà, Marina Pont, María Purificación Martínez del Prado, Alberto Loizate Totorikaguena, Ignacio Zabalza Estévez, José Errasti Alustiza, Antonio Z. Gimeno–García, Santiago Lázaro Aramburu, Mercè Comas Serrano, José M. Enríquez–Navascués, Carlos Placer Galán, Amaia Perales Antón, Iñaki Urkidi Valmaña, José María Erro Azkárate, Enrique Cormenzana Lizarribar, Adelaida Lacasta Muñoa, Pep Piera Pibernat, Elena Campano Cuevas, Ana Isabel Sotelo Gómez, Segundo Ángel Gómez‐Abril, F. Medina-Cano, Julia Alcaide, Arturo Del Rey-Moreno, Manuel Jesús Alcántara, Rafael Campo, Àlex Casalots, Carles Pericay, María José Gil Quílez, Miquel Pera, P Collera, Josep Alfons Espinàs, Mercedes Martínez, Mireia Espallargues, Caridad Almazán, Paula Dujovne Lindenbaum, José María Fernández‐Cebrián, Rocío Anula Fernández, Julio Mayol, Ramón Cantero Cid, Héctor Guadalajara, María Alexandra Heras Garceau, Damián García‐Olmo, Mariel Morey Montalvo,

Colorectal and Anal Carcinomas

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.