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. 2020 Dec 30:2020:7434783.
doi: 10.1155/2020/7434783. eCollection 2020.

The Survival Advantage of Females at Premenopausal Age Is Race Dependent in Colorectal Cancer

Hui Sheng  1 , Xiaoli Wei  2 , Qunxi Chen  3 , Kewei Huang  4 , Runkun Han  4 , Yijun Liu  4 , Wen Liu  4 , Minjie Mao  4
Affiliations

The Survival Advantage of Females at Premenopausal Age Is Race Dependent in Colorectal Cancer

Hui Sheng et al. Biomed Res Int. .

Abstract

Background: A female prognostic advantage in younger individuals has been demonstrated in various cancers. Several large-scale analyses based on different racial backgrounds have reported inconsistent results in colorectal cancer. The aim of the present study was to evaluate the prognostic value of sex and age in patients with colorectal cancer of different ethnic groups.

Methods: We identified 71,812 eligible patients from the Surveillance, Epidemiology and End Results database. According to age at diagnosis, the patients were categorized into premenopausal age (≤45 yrs), menopausal age (46-54 yrs), and postmenopausal age (≥55 yrs) subgroups for further analysis.

Results: Multivariate analysis identified the female survival advantage to be significant in the premenopausal age subgroup (P = 0.002, HR (95% CI): 0.73 (0.60-0.89)), diminished in the menopausal age subgroup (P = 0.09), and absent in the postmenopausal age subgroup (P = 0.96). Furthermore, the female survival advantage at premenopausal age was significant only in white patients (P = 0.001, HR (95% CI): 0.68 (0.54-0.87)) and not in either American Indian/Alaska Native or Asian or Pacific Islander patients. There was a trend of better survival of females in black patients (P = 0.07).

Conclusions: Sex was a major prognostic factor in colorectal cancer patients, especially premenopausal women, and the difference was also associated with race.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
Sex differences in colorectal cancer-specific overall survival in colorectal cancer patients stratified by age. Survival was estimated by the Kaplan-Meier method and compared with the log-rank test, and a survival advantage in female patients was found in the premenopausal age subgroup (P < 0.001) that diminished in the menopausal age subgroup (P = 0.09) and was reversed in the postmenopausal age subgroup (P < 0.001).
Figure 2
Figure 2
Sex differences in colorectal cancer-specific overall survival in colorectal cancer patients at premenopausal age stratified by race. Survival was estimated by the Kaplan-Meier method and compared with the log-rank test. The survival advantage of females only existed in black (P = 0.003) and white (P = 0.01) patients and not American Indian/Alaska Native (P = 0.94) or Asian or Pacific Islander (P = 0.36) patients.
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