Cancer: Are women less affected by it?

Women generally cope better with illnesses. Moreover, their life expectancy, 85 years on average, is greater than that of men, which is 79 years. For a long time, this difference was explained by different lifestyles. Also, women's bodies allow them to be more protected than men.

What biological characteristics protect women from illnesses better than men?

All body cells have chromosomes, which contain all genetic information. Sex chromosomes in females are XX, those of males are XY. Having two X chromosomes allows for a double protection against conditions related to this particular chromosome, such as haemophilia or Duchenne muscular dystrophy. This means that the double dose of the X gene inhibits or favors certain mechanisms. This does not work for men, so they are more likely to develop these conditions.

Also, the X-chromosome is larger than the Y-chromosome, it contains more than 1000 genes, a large part of which is related to immunity. This may explain why 59% of patients who die of severe Covid-19 are men, while 52.4% of those affected are women.

Estrogen, a sex hormone produced by the ovaries, is protective against stroke and other cardiovascular diseases, until the menopause sets in. On the other hand, due to hormonal changes that occur throughout their life, women are more prone to migraines, osteoporosis and thyroid disease (e.g. Hashimoto's Thyroiditis).

In general, women produce more protective antibodies against viruses, bacteria and parasites. However, this advantage can be harmful in case of an autoimmune disease: that is why women are more affected by such conditions as multiple sclerosis, rheumatoid arthritis or lupus. Another danger is the increased risk of side effects in case of vaccination. As far as cancer is concerned, there is a difference between men and women, since this disease involves numerous mechanisms related to immunity. But in recent years, women's lifestyle has changed and their genetic and hormonal advantage has less impact than before.

What do we know about cancer in women?

1 in 6 women will develop cancer during their lifetime.

The median age of cancer diagnosis for women is 67 years. Over the last decade, the incidence rate has remained almost the same in men, and has increased in women (+5%).

The most frequent cancers in women are breast (30%), lung (13%) and bowel cancer (10%).

Breast cancer is the most deadly cancer in women, affecting more than 55,000 women every year. If it is detected early, like in 60% of cases, it has good prognosis, the treatment is more efficient and the side effects of certain treatments can be limited.

Female cancers include breast cancer, even if men can also be affected, and gynecological cancers such as cervical cancer, ovarian cancer, vaginal cancer, vulvar cancer and gestational trophoblastic tumors.

What causes cancer in women?

According to the WHO, 30 to 50% of all cancers are preventable.

Risk factors, especially for cancers common to both women and men (lung, bowel, pancreatic and liver) are:

• Age,
• Active and passive smoking and alcohol consumption,
• Occupational exposures and environmental pollution,
• Family history and genetic predisposition,
• Excess weight and lack of physical activity,
• The presence of polyps,
• Being a carrier of Lynch syndrome, having familial adenomatous polyposis or inflammatory diseases,
• Having or having had hepatitis B, hepatitis C, non-alcoholic fatty liver disease, hemochromatosis,
• Exposure to the sun and/or artificial UV, history of sunburn,
• A large number of moles,
• Immunosuppression.

For female cancers, other risk factors include:

• Certain menopausal hormone treatments,
• Not breastfeeding your child,
• Human papillomavirus (HPV),
• Early sexual intercourse,
• Having multiple partners,
• Multiparity (having given birth several times) or nulliparity (never having given birth),
• Prolonged use of hormonal contraceptives,
• Early menarche or late menopause.

How are women screened for cancer? 

Screening allows for early diagnosis.

From the beginning of sexual activity until at least the age of 75, women must undergo an annual clinical examination, and a cervical screening (a smear test) from ages 25 to 65, every 3 to 5 years.

A mammogram for breast cancer screening is also recommended every 2 years for women aged 50 to 74. Also, physicians strongly encourage all women to perform regular breast self-evaluation, in-between doctor’s appointments.

An immunological screening test for blood in the stool is also recommended for people over 50. It should be carried out every two years, and should be followed by a colonoscopy if the result is positive and shows a risk of bowel cancer.

There are also some warning signs to consider. For example, a family history of BRCA1 and BRCA2, having a lot of moles, blood loss after menopause, as well as transit disorders and abdominal pain for no particular reason.

Why is the gap between women and men affected by cancer closing?

In 2016-2018, epidemiological data on cancer revealed that the incidence of new cases had remained stable in men, but had increased in women, by 5%.

Over the last decade, mortality from all cancers combined has declined in both sexes. Among men, the mortality rate has decreased by 12%, while among women it has decreased by 9%. For women, this can be partly explained by the significant increase in deaths due to lung cancer.

Women are smoking more and more, and one of the main consequences of smoking is lung cancer, the incidence of which has been increasing in women. Healthcare professionals are worried by this evolution, because of the poor survival prognosis for this type of cancer.

Alcohol consumption among women has also increased, as well as changes in eating habits have taken place, thus generating problems related to excess weight, obesity and high blood pressure, all of which represent risk factors for developing cancer.

Another type of cancer which concerns healthcare professionals, due to the increase in cases in recent years, is cervical cancer. It is the second most common cause of death in women of reproductive age, although it can be prevented and often cured. The World Health Organisation (WHO) has chosen January as the month to raise awareness about the prevention of this disease.

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