566eP Ambient particulate matter and lung cancer risk in low- and middle-income countries: A meta-analysis

Background:We aimed to expand understanding of gender-specific patient experiences across the lung cancer (LC) journey, including quality of life (QoL), mental health, the impact of adverse events (AEs) on well-being, and the long-term implications for survivorship.Methods: A systematic literature review was conducted using a PICOS framework to identify publications reporting on gender differences in patients with LC.Embase, MEDLINE, MEDLINE In-Process, and Cochrane databases were searched for Englishlanguage publications (Jan 2004 to Feb 2024).Excluded studies did not report on the population, study design, outcomes, language, and/or timeframe outlined in the framework.Data from articles providing adjusted estimates of gender comparison using regression analysis were reported.Results: Initial searches identified 5,166 unique publications reporting on the continuum of care and 689 on survivorship, of which 1,318 and 296 were reviewed in full, respectively.The final review included publications reporting on gender differences in mental health and QoL (n=30), AEs (n=6), and survivorship (n=7), covering approximately 1.7 million patients.In 5/6 studies, women reported lower QoL scores following LC treatment compared with men, including lower emotional well-being (3/ 4 studies, : -1.49 to -1.83) and worse physical QoL (2/2 studies, : -2.44 to -6.44).9/ 10 studies showed a significantly higher incidence of depression (OR: 1.44-2.11)and 3/4 studies reported higher rates of anxiety for women vs men.Three studies found that women were more likely than men to use psychosocial services and receive supportive end-of-life care.Six studies assessed the incidence of AEs following LC treatment; most found that women had significantly higher risk of experiencing certain AEs compared with men (e.g.fatigue, appetite loss, diarrhea), potentially associated with worse physical and emotional QoL, although men reported more cardiac-related toxicities and acute kidney injury. Conclusions:Women with LC report worse QoL, greater emotional burden, and higher rates of AEs compared with men.These disparities highlight the need for gender-informed care approaches with a focus on gender-tailored interventions.