Men Face Higher Odds of Later-Stage Diagnosis Across 20 Cancer Types

Men were more likely than women to be diagnosed with regional or distant disease across 20 of 30 nonreproductive solid tumor sites, according to a large US registry analysis. The findings suggest that stage at diagnosis may contribute to long-established sex differences in cancer mortality and identify opportunities for earlier recognition, patient education, and timely referral.¹ Clinical experts have suggested that biological, behavioral, social, and health care access factors may collectively contribute to these disparities.²

Broad Disparities Across Cancer Sites

Using the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) 21 database, the study investigators analyzed 2,401,772 cancers diagnosed from 2015 through 2022, excluding 2020. SEER registries collect information about patient demographics, primary tumor site, tumor morphology, stage at diagnosis, initial treatment, and vital status.³ Men comprised 56.9% of the study population, and approximately 45% of cancers were localized at diagnosis.

Using polytomous logistic regression adjusted for age and diagnosis year, investigators compared the odds of regional and distant disease with localized disease for each cancer site. Men had significantly greater odds of regional-stage diagnosis for 16 cancers and distant-stage diagnosis for 17.¹

The largest regional-stage disparity involved tongue cancer (adjusted odds ratio [aOR], 2.51; 95% CI, 2.40-2.64), followed by salivary gland (aOR, 1.93), oropharyngeal (aOR, 1.80), thyroid (aOR, 1.74), and stomach cancers (aOR, 1.67). Men also had higher odds of regional-stage lung and bronchus cancer (aOR, 1.25) and kidney and renal pelvis cancer (aOR, 1.22).²

For distant disease, the highest male predominance occurred in tongue (aOR, 2.34), thyroid (aOR, 2.28), salivary gland (aOR, 1.97), stomach (aOR, 1.56), and melanoma (aOR, 1.50). Higher odds were also observed for cancers of the bones and joints, lung and bronchus, and kidney and renal pelvis.²

The pattern was not universal. Men had lower odds of regional-stage laryngeal and bladder cancers and lower odds of distant-stage bladder, anal, and liver cancers. Similar patterns generally persisted across racial and ethnic groups and county-level income strata, although the magnitude varied by cancer site.¹

Findings Highlight Opportunities for Patient Education

Beth Maclin, PhD, MPH, postdoctoral fellow in the Infections and Immunoepidemiology Branch at the NCI and lead study author, said the overall prevalence of the disparities was particularly notable.

“The sheer number of cancer sites that showed larger odds of males being diagnosed later was surprising, but these specific sites were not particularly shocking given known sex patterns in cancer incidence for them,” Maclin said in an interview with Pharmacy Times. She noted, for example, that thyroid cancer is more commonly diagnosed in women.

Although the study did not investigate the causes of the disparities, Maclin said previous research points toward several possible explanations. Women may seek health care more frequently, creating additional opportunities for clinicians to recognize symptoms and order diagnostic testing. Previous research has similarly found greater use of preventive care services among women than men.⁴

“Clinicians may perceive symptoms in their patients through a sex-specific lens, which could inform who gets further testing and when,” Maclin explained. “There are also biological factors that influence tumor growth, which could cause tumors to grow faster in males, making it more difficult to catch tumors at the localized stage.”

Jose Barreau, MD, of PreOncology, told MedPage Today that men may also be less likely to establish ongoing primary care relationships or seek evaluation until symptoms develop. Work schedules, access barriers, and traditional expectations surrounding masculinity may further contribute to delayed care.²

Study Limitations Require Cautious Interpretation

SEER staging is less granular than the tumor-node-metastasis system commonly used in clinical care, and the database lacked variables such as insurance coverage and health care utilization that might explain some of the observed patterns. Missing stage information also exceeded 10% for several cancer sites. Consequently, the results demonstrate associations but cannot establish that sex itself caused later diagnosis.¹

Additional research will be needed to distinguish the contributions of tumor biology, screening participation, health care access, symptom recognition, and clinician decision-making.

Pharmacists Can Reinforce Early-Detection Messages

Maclin identified patient education as one of the clearest clinical implications of the findings.

“We found that males were more likely to be diagnosed at the regional and/or distant stage compared with females for two-thirds of the 30 nonreproductive cancer sites we examined. I think clinicians have an enormous role to play in educating their patients about cancer risks and symptoms as well as established screening programs,” she said. “The more patients know, the better able they will be to identify concerning symptoms and advocate for themselves during medical appointments, which will hopefully mean earlier diagnosis.”

For pharmacists, frequent patient contact creates opportunities to reinforce evidence-based colorectal and lung cancer screening, identify patients who may be overdue for primary care, and encourage evaluation of persistent or concerning symptoms. Medication reviews may also provide natural openings to discuss tobacco exposure, family history, prior screening, or unexplained changes in health.

Broad population screening is not recommended for every cancer highlighted in the analysis. Recommendations vary by cancer site, age, smoking history, and individual risk, and evidence remains insufficient or unfavorable for routine screening of several cancers with pronounced disparities.⁵ Pharmacists should therefore align counseling with applicable guidelines while supporting timely referrals and helping patients overcome practical barriers to follow-up.

Maclin said her next analysis will examine differences in stage at diagnosis by race and ethnicity and urbanicity, focusing specifically on female reproductive cancers.

“Stage at diagnosis is an exciting focus of study because it allows us to identify potential intervention points to encourage earlier detection, which may then improve survival,” she said.

REFERENCES

1. Maclin B, Shiels M, Bhattacharjee P, et al. Sex Differences in Cancer Stage at Diagnosis of Nonreproductive Solid Organ Tumors in the United States, 2015 to 2022. Cancer Epidemiol Biomarkers Prev. 2026;35(7):1166-1173. doi:10.1158/1055-9965.EPI-25-1826

2. Bankhead C. In 20 Different Cancers, Men More Likely to Be Diagnosed at a Later Stage. MedPage Today. July 9, 2026. Accessed July 20, 2026. http://bit.ly/4gO3T9j

3. SEER incidence data, 1975-2023. National Cancer Institute. Accessed July 20, 2026. https://seer.cancer.gov/data/

4. Vaidya V, Partha G, Karmakar M. Gender differences in utilization of preventive care services in the United States. J Womens Health (Larchmt). 2012;21(2):140-145. doi:10.1089/jwh.2011.2876

5. Cancer Screening Recommendations. US Preventive Services Task Force. Accessed July 20, 2026. https://bit.ly/3Tu5ZkZ