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Disparities between male and female patients with thyroid cancers: sex difference or gender divide?
Author(s) -
Machens Andreas,
Hauptmann Steffen,
Dralle Henning
Publication year - 2006
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2006.02623.x
Subject(s) - medicine , medullary cavity , medullary thyroid cancer , thyroid , lymph node , medullary carcinoma , thyroid cancer , follicular phase , cancer , papillary thyroid cancer , stage (stratigraphy) , oncology , pathology , gastroenterology , thyroid carcinoma , biology , paleontology
Objective This investigation was undertaken to quantify histopathological disparities between male and female patients with sporadic and hereditary thyroid cancers, which may reflect a biological ‘sex difference’ or a behavioural ‘gender divide’. Design Retrospective cohort analysis (November 1994–January 2006). Patients 1298 consecutive surgical patients with sporadic papillary ( n = 587), sporadic follicular ( n = 232), sporadic medullary ( n = 320), and hereditary medullary thyroid cancers ( n = 159) from a tertiary referral centre. Measurements Age at diagnosis of cancer, primary tumour diameter, frequency of extrathyroidal extension, lymph node and distant metastases, and cancer subtypes. Results Primary diameters of sporadic tumour entities (papillary, 26·0 vs. 19·3 mm; follicular, 54·9 vs. 35·1 mm; and medullary, 27·9 vs. 20·8 mm), but not hereditary medullary cancers, were significantly ( P ≤ 0·001) larger in male patients. Likewise, lymph node metastases from sporadic papillary cancers (60% vs. 44%, P < 0·001), the insular subtype in sporadic follicular cancers (22% vs. 8%, P = 0·003), extrathyroidal extension of sporadic medullary cancers (35% vs. 15%, P < 0·001), and distant metastases from sporadic medullary cancers at the most recent operation (29% vs. 15%, P = 0·002) were seen significantly more often with male patients. No significant differences were observed between male and female patients with hereditary medullary cancers, half of which were detected by screening. Conclusions Our data emphasize the need for earlier diagnosis and intervention in male patients to ensure that male sex will cease sometime to constitute an ominous prognostic marker of advanced thyroid cancer.