Sex-Based Differences in Clinicopathologic Features and Survival Outcomes in Colon Cancer

Öz

Objective: Sex-related differences in the epidemiology and clinical behavior of colon cancer have gained increasing attention, yet existing findings remain inconsistent. This study aimed to compare demographic, clinicopathologic characteristics and survival outcomes between female and male patients with colon cancer using a large population-based cohort from the SEER database. Methods: This retrospective cohort study included adults diagnosed with colon cancer between 2010-2021 in the Surveillance, Epidemiology, and End Results(SEER) program. Cases with appendiceal or rectal tumors, diagnosis by autopsy or death certificate, missing sex information, or incomplete survival data were excluded. Demographic and tumor-related variables were compared using the chi-square test. Overall survival(OS) and cancer-specific survival(CSS) were estimated with Kaplan-Meier analysis and compared using the log-rank test. Cox proportional hazards models were applied to evaluate the independent effect of sex on survival. Results: A total of 314,706 patients were included(154,387 women;160,319 men). Women were older at diagnosis and more frequently had right-sided tumors, mucinous histology, and high-grade disease. Men more often presented with stage IV disease and had higher rates of cardiovascular and other-cause mortality. OS favored women across all time points(10-year OS:37.6%vs.35.7%), while long-term CSS was similar(10-year CSS:62.8%vs.62.6%). In multivariable analyses, male sex remained an independent adverse prognostic factor for OS (HR 1.21) and CSS (HR 1.10). Conclusion: This large-scale population-based analysis demonstrates clear sex-related differences in the presentation and prognosis of colon cancer. Male sex is an independent predictor of poorer survival, underscoring the need for sex-sensitive and individualized management strategies.

Anahtar Kelimeler

• Colon cancer
• sex differences
• Survival
• Prognosis

Kolon Kanserinde Klinikopatolojik Özellikler ve Sağkalım Sonuçlarında Cinsiyete Dayalı Farklılıklar

Öz

Giriş: Kolon kanserinde cinsiyete bağlı epidemiyolojik ve klinik farklılıklar giderek daha fazla ilgi görmekle birlikte, mevcut bulgular tutarsızdır. Bu çalışmada, SEER veritabanı kullanılarak kadın ve erkek kolon kanseri hastaları arasında demografik özellikler, klinikopatolojik bulgular ve sağkalım sonuçlarının karşılaştırılması amaçlandı. Gereç ve Yöntem: Bu retrospektif kohort çalışmasına, Surveillance, Epidemiology, and End Results (SEER) programında 2010–2021 yılları arasında kolon kanseri tanısı almış ≥18 yaş hastalar dahil edildi. Appendiks ve rektum tümörleri, otopsi ya da ölüm belgesi ile tanı alan olgular, cinsiyet bilgisi veya sağkalım verisi eksik olan hastalar çalışma dışı bırakıldı. Demografik ve tümöre ait değişkenler ki-kare testi ile karşılaştırıldı. Genel sağkalım (OS) ve kansere özgü sağkalım (CSS) Kaplan–Meier yöntemi ile değerlendirildi ve log-rank testi ile karşılaştırıldı. Cinsiyetin sağkalım üzerindeki bağımsız etkisi Cox regresyon analizi ile incelendi. Bulgular: Toplam 314.706 hasta analiz edildi (154.387 kadın, 160.319 erkek). Kadınlar tanı anında daha ileri yaşta olup sağ kolon yerleşimli, müsinöz histolojili ve yüksek dereceli tümörlere daha sık sahipti. Erkeklerde evre IV hastalık, kardiyovasküler ve kanser dışı mortalite oranları daha yüksekti. Genel sağkalım tüm zaman noktalarında kadınlar lehineydi (10 yıllık OS: %37,6 vs. %35,7). Uzun dönem CSS ise benzerdi (10 yıllık CSS: %62,8 vs. %62,6). Çok değişkenli analizlerde erkek cinsiyet OS ve CSS için bağımsız kötü prognostik faktör olarak saptandı. Sonuç: Bu geniş ölçekli popülasyon temelli analiz, kolon kanserinde cinsiyete bağlı belirgin klinik ve prognostik farklılıklar olduğunu göstermektedir. Erkek cinsiyetin sağkalım açısından olumsuz bir belirleyici olması, klinik uygulamada cinsiyete duyarlı yaklaşımların önemini vurgulamaktadır.

Anahtar Kelimeler

• Kolon kanseri
• cinsiyet farkları
• sağkalım
• prognoz

Kaynakça

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