Sex Differences in Cancer Stage at Diagnosis of Nonreproductive Solid Organ Tumors in the United States, 2015 to 2022

BACKGROUND: Men are more likely to die from cancer than women, which may partly be explained by differences in diagnosis stage. This pan-cancer analysis examined sex differences in cancer stage at diagnosis for nonreproductive solid organ tumors across 30 cancer sites. METHODS: We used data from the Surveillance, Epidemiology, and End Results 21 database (2015-2022, excluding 2020). We conducted multiple polytomous logistic regression to assess the association between sex and stage of disease (localized vs. regional and localized vs. distant) for each site, adjusted for age and diagnosis year. We further conducted stratified analyses based on race and ethnicity and county-level median household income. RESULTS: Of the 30 sites examined, males had greater odds of being diagnosed at regional and/or distant stages compared with the localized stage for 20 sites, while having lower odds of being diagnosed at the later stages for four sites, compared with females. When examining distant stage, the site with the largest adjusted odds ratios (aOR; i.e., male predominance) was the tongue [aOR = 2.34; 95% confidence interval (CI), 2.16-2.53]; the smallest aOR (i.e., female predominance) was for the bladder (aOR = 0.69; 95% CI, 0.66-0.72). CONCLUSIONS: For most sites we examined, males were significantly more likely to be diagnosed at regional or distant staging than localized staging when compared with females. IMPACT: Further investigation is warranted to elucidate the mechanisms driving sex-based differences in stage at diagnosis and to identify effective, targeted intervention strategies aimed at reducing diagnostic disparities, particularly among males.