Gender differences in cancer epidemiology in Italy, 2013–2017

Gender differences in cancer burden have been consistently reported worldwide, with men exhibiting higher incidence and mortality rates for most non-sex-specific cancers. However, the extent and patterns of these disparities across cancer sites, age groups, and geographical regions in Italy remain poorly investigated. We analysed data from population-based cancer registries belonging to the AIRTUM network, including 1359,053 cancer cases diagnosed between 2013 and 2017, overall and stratified by age group (0–49, 50–69, ≥70 years) and by geographic macro-areas (North, Centre, South 95% confidence interval CI: 1.38–1.39), and this gap increased when excluding breast cancer (M/F IRR = 1.90; 95% CI: 1.89–1.90). Male predominance was observed in 29 of 30 sites, most notably laryngeal (M/F IRR = 8.74; 95% CI: 8.31–9.19), bladder (5.23; 95% CI: 5.15–5.32), mesothelioma (3.60; 95% CI: 3.40–3.82), and lung (2.92; 95% CI: 2.89–2.95) cancers, while thyroid cancer was more common in women (0.37; 95% CI: 0.36–0.38). Incidence gender gaps were greater in the South & Islands than in the North and Centre. Women showed higher five-year survival rates than men for most major cancers, including colorectal and lung. In Italy, men bear a substantially higher cancer burden than women, with significant geographical variability, while women consistently achieve better survival outcomes. Biological, behavioural, and sociocultural factors likely contribute to these differences. Addressing these disparities requires incorporating a gender perspective into cancer prevention, early detection, and treatment strategies. • The male-to-female cancer incidence rate ratio was 1.38 for all cancers. • It increased to 1.90 when sex-specific and breast cancers were excluded. • Male predominance was observed for 29 cancer sites including lung, bladder and larynx, while thyroid predominated in women. • An age-related inversion was observed, with female predominance at younger ages shifting to male predominance at older ages. • Women had higher survival rates for many types of cancer.