Sex disparities in lung cancer: Results of the KBP-2020-CPHG study
Menée en France à partir de données 2020 portant sur 3 095 femmes et 5 846 hommes atteints d'un cancer du poumon, cette étude examine les caractéristiques de la maladie et la survie en fonction du sexe
Introduction: The KBP-CPHG observational studies, conducted every 10 years, have shown a significant increase in the proportion of women with lung cancer, rising from 16.0 % in 2000 to 34.6 % in 2020 (P < 0.0001). We report differences in clinical, tumor, and prognostic characteristics between women and men.
Methods: All patients with primary lung cancer diagnosed in 2020 across 81 French centers were included. Patient and tumor characteristics were compared by sex. Patients in the KBP-2020 cohort were also compared with those from the 2000 and 2010 cohorts.
Results: The KBP-2020 study included 3,095 women and 5,846 men. Smoking was more frequent in men (93.6 %) than in women (75.7 %). Women were diagnosed at a younger age (median 66.8 vs 68.6 years; P < 0.0001) and had slightly better performance status (0–1: 76.2 % vs 73.7 %; P < 0.001). Adenocarcinoma predominated in both sexes but was more frequent in women (65.5 % vs 51.0 %; P < 0.0001). Molecular testing was performed more often in women (64.5 % vs 52.3 %; P < 0.0001) and identified more genetic alterations (58.2 % vs 42.1 %; P < 0.0001). Among stage IV adenocarcinoma cases, EGFR mutations were more frequent in women (27.5 % vs 7.9 %; P < 0.001).
Women had better overall survival than men (4-year OS: 34.7 % vs 23.7 %; median OS: 21.9 vs 12.6 months; P < 0.0001). Female sex was associated with improved survival in multivariable analysis (HR 0.79; 95 % CI 0.74–0.84; P < 0.0001). This association was no longer significant in a stage IV NSCLC–restricted model including an interaction with first-line treatment (HR 0.88; 95 % CI 0.77–1.02; P = 0.087).
Conclusion: Women with lung cancer had better survival than men, but this advantage was no longer significant after adjustment for treatment differences.
Lung Cancer , résumé, 2026