Global Sex Differences in Cancer Mortality with Age and Country Specific Characteristics

Background: The cancer research literature suggests that women, especially premenopausal women, have lower cancer mortality rates than men. However, it is unclear if that is true for populations at all age levels in all countries and what factors affect such sex differences. This paper attempts to fill that gap. Materials and Methods: Sex- and country-specific cancer mortality data were statistically analyzed with particular attention to geographic, social, and economic factors that may affect the sex differences. Results: The sex differences were age and country specific, rather than universal. Premenopausal women actually tend to have a disadvantage compared to men or postmenopausal women. Male cancer mortality appears to be the affecting factor in explaining variations in sex differences. Latitude of residence and literacy rate are the affecting factors in cancer mortality and sex differences. African and Latin American countries tend to have a female disadvantage, while East Asian and Eastern European countries are more likely to have a female advantage. Conclusions: The findings challenge the cancer mortality literature and indicate that the sex differences and their possible causes are more complicated than the current literature suggests. They also highlight the urgency of adapting age- and country- specific health systems and policies to better meet the needs of younger women.