Background/Objectives:Non-small cell lung cancer (NSCLC) has seen a relative rise in incidence among females versus males in recent years, although males still have a higher overall incidence. However, it is unclear whether this trend is consistent across all populations. Therefore, we retrospectively examined this relationship in two large high-risk clinical cohorts.Methods:First, we analyzed lung cancer incidence among individuals with a smoking history of over 40 pack-years in the National Lung Screening Trial (NLST). Then, we investigated the incidence of second primary NSCLC in patients who underwent lobectomy for previous stage I lung cancer using the Surveillance, Epidemiology, and End Results (SEER) database. We performed both univariate and multivariable time-to-event analyses to investigate the relationship between sex and lung cancer incidence.Results:In the NLST cohort (n = 37,627), females had a higher risk of developing primary NSCLC than males (HR = 1.11 [1.007–1.222],p= 0.035) after adjusting for age and pack-year history. In the SEER cohort (n = 19,327), females again exhibited an increased risk of developing a second primary lung cancer (HR = 1.138 [1.02–1.269],p= 0.021), after adjusting for age, race, grade, and histology.Conclusions: Our analysis reveals that females have a modestly higher lung cancer incidence than males in high-risk populations. These findings underscore the importance of further researching the underlying cellular processes that may cause sex-specific differences in lung cancer incidence.
背景/目的：近年来，非小细胞肺癌（NSCLC）在女性中的发病率相较于男性呈相对上升趋势，尽管男性的总体发病率仍然更高。然而，尚不清楚这一趋势是否在所有人群中保持一致。因此，我们回顾性分析了两个大型高风险临床队列中的这一关系。方法：首先，我们分析了国家肺部筛查试验（NLST）中吸烟史超过40包年的个体的肺癌发病率。随后，利用监测、流行病学和最终结果（SEER）数据库，我们调查了因既往I期肺癌接受肺叶切除术的患者中第二原发NSCLC的发病率。我们进行了单变量和多变量事件发生时间分析，以探讨性别与肺癌发病率之间的关系。结果：在NLST队列（n = 37,627）中，调整年龄和包年吸烟史后，女性发生原发性NSCLC的风险高于男性（HR = 1.11 [1.007–1.222]，p = 0.035）。在SEER队列（n = 19,327）中，调整年龄、种族、分级和组织学类型后，女性再次显示出发生第二原发肺癌的风险增加（HR = 1.138 [1.02–1.269]，p = 0.021）。结论：我们的分析表明，在高风险人群中，女性的肺癌发病率略高于男性。这些发现强调了进一步研究可能导致肺癌发病率存在性别差异的潜在细胞过程的重要性。
肿瘤(癌症)患者之家