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Meta-Analysis
. 2019 Oct 25;19(1):1001.
doi: 10.1186/s12885-019-6168-1.

Female sex is associated with a lower risk of bone metastases and favourable prognosis in non-sex-specific cancers

Wenjuan Ma  1 , Karl Peltzer  2 , Lisha Qi  3 , Guijun Xu  4 , Zheng Liu  4 , Jingyi Wang  3 , Min Mao  5 , Vladimir P Chekhonin  6 , Xin Wang  7 , Chao Zhang  8
Affiliations
Meta-Analysis

Female sex is associated with a lower risk of bone metastases and favourable prognosis in non-sex-specific cancers

Wenjuan Ma et al. BMC Cancer. .

Abstract

Background: The objectives were to investigate the disparity in the prevalence of bone metastases (BM) between the sexes and to assess the effect of female sex on the development and prognosis of BM.

Methods: Cases of invasive non-sex-specific cancers diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) program were used. The prevalence of BM was calculated by combining the prevalence of BM among different cancers. Multivariable logistic regression and proportion hazard regression were conducted to investigate the effect of female sex, and the results were pooled by meta-analysis.

Results: The pooled prevalence of BM among male and female patients was 2.3% (95% CI: 1.6-3.2%) and 1.8% (95% CI: 1.2-2.6%), respectively. The pooled prevalence of BM dramatically decreased for patients aged 11-40 years old, plateaued for patients aged 41-90 years old and increased for patients aged > 90 years old in both male and female patients. Meta-analysis suggested that female sex had a protective effect on the development of BM (pooled OR = 0.80; 95% CI: 0.75-0.84; p < .001) and a favourable prognosis for respiratory system cancers (pooled HR = 0.81; 95% CI: 0.71-0.92; p < .001). However, no significant associations existed for other cancers. Male non-sex-specific cancer patients and those with male-leaning genetic variations or hormonal status have a greater likelihood of developing BM than female patients.

Conclusions: Female sex was associated with fewer BM in various non-sex-specific cancers, and the effect was constant with changes in age. Female sex showed a protective effect exclusively on the prognosis of respiratory system cancers.

Keywords: Bone metastases; Prevalence; Prognosis; SEER; Sex disparity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow-chart of the non-sex-specific cancer patient selection procedure
Fig. 2
Fig. 2
Forest plot for the prevalence of bone metastases across different non-sex-specific cancer types and the pooled prevalence of bone metastases in male patients, female patients and the total population. (For detail information of the figure, please see https://pan.baidu.com/s/1VU4VpV7w90S9k-FHuKS8LQ, password: p55j)
Fig. 3
Fig. 3
Forest plot for the pooled prevalence of bone metastases for different non-sex-specific cancer systems in male patients, female patients and the total population. (For detail information of the figure, please see https://pan.baidu.com/s/1VU4VpV7w90S9k-FHuKS8LQ, password: p55j)
Fig. 4
Fig. 4
The pooled female and male prevalence of bone metastases and the female-to-male prevalence ratio across different age groups
Fig. 5
Fig. 5
Forest plot for the effect of female sex on the development of bone metastases across different non-sex-specific cancer types and the pooled effect for different non-sex-specific cancer systems and the total population. (For detail information of the figure, please see https://pan.baidu.com/s/1VU4VpV7w90S9k-FHuKS8LQ, password: p55j)
Fig. 6
Fig. 6
Forest plot for the effect of female sex on the prognosis of bone metastases across different non-sex-specific cancer types and the pooled effect for cancers of different systems and the total population. (For detail information of the figure, please see https://pan.baidu.com/s/1VU4VpV7w90S9k-FHuKS8LQ, password: p55j)
See this image and copyright information in PMC

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