Multicohort study of disparities in cancer incidence by sex and associated lifestyle factors and health conditions

Globally, cancer incidence is higher in males than females. Whether this sex disparity reflects a biological inevitabililty or is potentially modifiable by lifestyle behaviors and health conditions across diverse populations is not clear. A multicohort study of 3 population-based prospective cohorts in China (Shanghai Men’s Health Study and Shanghai Women’s Health Study) and the UK (UK Biobank) of adults aged 40 to 74 years at baseline with no prior cancer determined the contribution of lifestyle factors and health condition to sex disparities in cancer incidence. Baseline data were collected form 1997 to 2010, with follow-up through 2021. Data were collected on 11 risk factors covering behaviors (smoking, heavy alcohol drinking, physical inactivity), diet (low intakes of vegetables and fruit, high intakes of red meat and processed meat), and health conditions (cholelithiasis, chronic liver diseases, diabetes, obesity). In this study of 589,766 participants, the 11 factors jointly accounted for 84% of the male-female gap in non-sex-specific cancer incidence (183 cases per 100,000 person-years) in the Chinese population but only 26% (52 cases per 100,000 person-years in the UK population. The authors conclude that these findings suggest that the contribution of modifiable lifestyle behaviors and health condition to the male-female cancer gap varies across populations, underscoring the need for population-specific prevention.