Gastric cancer is the second most prevalent malignancy in men and the fourth most prevalent in women, and the overall incidence of gastric cancer is about 2.37 times higher in men than in women. The reason why stomach cancer “favors” men is probably related to a number of factors, both intrinsic and extrinsic.
Endogenous factors
In terms of endogenous factors, the difference in the incidence of gastric cancer in men and women may be related to the protective effect of estrogen on women. Studies have shown that postmenopausal women have a 1.59-fold increased risk of gastric cancer compared with nonmenopausal women and a 1.18-fold increased risk of gastric cancer for each 5-year advance in menopause. The reduced risk of gastric cancer in those receiving estrogen therapy and the increased risk of gastric cancer in those treated with anti-estrogenic drugs is indirect evidence of the protective effect of estrogen in women.
Exogenous factors
Poor lifestyle habits may be a factor in the gender differences in gastric cancer incidence, such as smoking and alcohol consumption.
Multiple harmful substances from tobacco combustion may damage the gastric mucosal barrier and stimulate gastric mucosal cells to become cancerous. A large number of studies have shown that the longer you smoke and the more you smoke, the higher the risk of developing gastric cancer. China’s survey shows that male smokers account for about 59.3% of the total male population, while female smokers account for only about 3.8%, and the number of male smokers is much higher than that of female smokers. Smoking may be one of the factors contributing to the difference in risk of gastric cancer in men and women.
Excessive intake of alcohol can not only damage the gastric mucosal barrier, but can also provide a more suitable environment for H. pylori to live in the stomach, exacerbating the damage to the gastric mucosa. The risk of gastric cancer is significantly higher in people who consume large amounts of alcohol compared to non-drinkers, and the risk of gastric cancer begins to increase when the amount of alcohol consumed is greater than 50g/day, and increases as the amount of alcohol consumed increases. The risk of gastric cancer begins to increase when the amount of alcohol consumed is greater than 50g/day, and the risk increases with higher alcohol consumption.
Gender differences in gastric cancer incidence may be due to estrogen protection as well as a variety of factors, and other well-known risk factors for gastric cancer such as H. pylori infection, chronic atrophic gastritis, and dietary habits have not yet been shown to contribute to gender differences. Although the incidence of gastric cancer worldwide is slowly decreasing year by year, the male-to-female ratio of gastric cancer incidence remains unchanged. Men seem to be more concerned about their stomach health. (Contributed by Jingxu Sun, Department of Gastrointestinal Oncology, The First Hospital of China Medical University)