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 & Islands). Differences in five-year net survival between men and women were also assessed. Overall, cancer incidence was markedly higher in men (male-to-female incidence rate ratio [M/F IRR] 1.38; 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.