28. Chemo FIT Part 6 More on Gender

If you read the last part of Fit (Part 4) you might recall that I touched briefly on gender differences.  Turns out something might be up with that.  I am relying on https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415207 for the following information.  The title is Fecal Immunochemical test-based colorectal cancer screening: The gender dilemma.  (2017)   I quote: "Differences in FIT screening between men and women can be explained by a combination of factors.  It has been suggested that because men have a higher hemoglobin concentration in general, blood from bleeding polyps will contain more hemoglobin.  As FIT specifically detects globin in feces, blood from these polyps could be detected more frequently in men.  This is supported by the fact that differences in fecal Hb concentration have been found in men and women. 

 A second explanation could be that women have more right-sided lesions, as it is known that fecal occult blood testing may not be as sensitive for proximal lesions as it is for distal lesions.  Yet our data did not show differences in location of advanced neoplasia (AN) between men and women.

Another reason for gender differences in FIT test characteristics could be the differences in colonic transit time between men and women, with women having slower transit times.  A slower transit time could lead to more degradation of hemoglobin and could decrease the likelihood of blood being detected by FIT.  ...

In absolute numbers, more advanced neoplasia are detected and missed in men for all cut-offs (of detection).  Adjusting cut-offs based on gender can contribute to the efficacy of FIT-based CRC screening programs and optimize the use of available endoscopy resources.  At present, men and women are informed in the same manner about FIT-based Colorectal Screening. ...  Individuals invited to attend a FIT-based CRC screening should be informed accordingly about these gender differences." End of quote.  (I could not find a copyright so presume it is all right to quote.)

Biomedical research has demonstrated biological differences between females and males in virtually every organ and system of the body. Research has also revealed the genetic and molecular basis of a number of gender-based differences in health and disease, some of which are related to genotype — XX in the female and XY in the male.

These findings suggest that there are multiple differences in the basic cellular biochemistry of males and females that can affect an individual's health. Many of these differences do not arise from differences in the hormonal regime to which males and females are exposed, but are a direct result of the genetic differences between the two sexes.

Further studies on the relative roles of the sex chromosome genes is likely to illuminate the reasons for expression of some diseases within and between the sexes. Understanding the bases of these gender-based differences is also important for the development of new approaches to disease prevention, diagnosis, and treatment.

source: ncbi-nlm-nih.gov