Question ID: WS-74
Submitted by: Neal Freedman
March 7, 2011
Why are the incidence rates of many cancers higher in men than women? Background: Throughout the world, a large number of different cancer types are more common in men than women. Only a few types of cancer, in contrast, are more common in women than men. For unknown reasons, sex is one of the strongest known risk factors for a number of cancer types. Perhaps the best example is for esophageal adenocarcinoma, where men are seven to ten times more likely to be diagnosed than women. Yet, the prevalence of known esophageal adenocarcinoma risk factors such as obesity and gastroesophageal reflux disease are similar in both sexes. Possible explanations include as yet unknown exposures that preferentially affect men or physiological differences between men and women, such as hormonal or epigenetic differences. Feasibility: Studies exist to examine exposures that may be more common in men or women. Though few studies have so far examined the role of epigenetic mechanisms, such as imprinting or differences between X and Y chromosome genetic content or gene expression, the advent of multiplex genomic tools now allows for the investigation of possible epigenetic sex differences in cancer risk. Multiplex approaches also exist to measure sex hormones; these could be applied to cancers with higher rates in men. Laboratory and non-human animal studies have also observed sex differences in tumor formation, these systems could be exploited in parallel to epidemiologic studies. Implications of success: Understanding the mechanisms responsible for higher cancer rates in men than women will likely provide fundamental etiologic insights into a large number of different cancer types and could also provide new avenues for cancer prevention and public health.
Average Score: 4.5
 (1 evaluation)Provocativeness - 5.0
Novelty - 4.0
Public Health Significance - 5.0
Feasibility - 4.0
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