Why men face higher cancer risks may depend on the country they live in
· Medical Xpressby Sanjukta Mondal, Medical Xpress
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Men bear a disproportionately higher burden of cancer even for cancers that are not specific to either sex. Although this pattern is global, the reasons for this difference remain mysterious. A recent study set out to investigate how much of this male-female cancer gap is solely rooted in biology and how much modifiable lifestyle habits and health conditions across populations play a role in driving it.
The analysis used data from two countries: China and the UK. The Chinese cohort brought together 134,742 adults living in urban Shanghai, combining two paired long-term studies: the women's and men's health studies. The UK Biobank added 455,024 male and female participants from 22 health centers. Across both datasets, the researchers examined 34 non-sex-specific cancer types and measured how much of the rate gap was caused by 11 modifiable risk factors.
In China, the 11 measured risk factors, including diet and metabolic diseases, accounted for 84.4% of the male-female cancer gap. The same explained only 26.2% of the sex gap in the UK, leaving nearly 74% of the disparity unexplained by the lifestyle factors being measured.
The findings are published in JAMA Oncology.
Not just biology
Men develop non-sex-specific cancers at rates much higher than women, but the factors driving this unnatural division of cells to a point where it can cause death can be governed by anything from genetics to environmental factors to lifestyle choices. This makes pinpointing the cause of this gap difficult.
Previous studies have hinted at biological differences playing a part, since genes, sex hormones, and the immune system can make men and women differently vulnerable. Others have suggested that everyday habits like smoking and diet, and metabolic disorders like diabetes and obesity, might also have a role to play. Understanding how much each factor contributes is important for designing public health efforts that target the right things.
In this study, researchers conducted a large-scale statistical analysis to determine how much of the male–female cancer gap is driven by lifestyle factors. They looked at 11 modifiable factors, including things like smoking, alcohol use, diet, and certain health conditions.
Then they followed the participants for more than a decade, using national and regional cancer registries up to 2020–2021 to track who went on to develop cancers that can affect both men and women.
- Circular bar plot of single-factor attributable rate difference (ARD) for the male-female incidence gap for Shanghai cohort. Credit: JAMA Oncology (2026). DOI: 10.1001/jamaoncol.2026.3747
- Circular bar plot of single-factor attributable rate difference (ARD) for the male-female incidence gap for UK population. Credit: JAMA Oncology (2026). DOI: 10.1001/jamaoncol.2026.3747
Same disease, different factors
Lifestyle choices drove most of the cancer gap between men and women in China, leaving only 15% accounted for by unexplained or biological factors.
In Shanghai, smoking was the single biggest factor, linked to about 52% of the gap, and heavy drinking accounted for another 15.1%. Both habits are culturally concentrated almost entirely among men, which creates a large difference in cancer rates between the sexes. Apart from these addictive habits, chronic liver diseases and low fruit intake also contributed to the gap.
In the UK, where men and women have much more similar smoking and drinking habits, the picture was quite different. It was metabolic conditions that became the leading measured driver of disparity. Obesity was the largest contributor, accounting for less than 8% of the gap, followed by smoking and type 2 diabetes, explaining 6.26% and 3.51% of the gap.
The findings show that the cancer gap between men and women is not set in stone by biological differences alone. Its causes vary heavily from country to country, depending on cultural habits and the overall health of each population; thus, the researchers suggest cancer prevention plans be customized to fit each population.
To strengthen these strategies, future studies first need to find out whether other major factors, such as environmental exposures or biological differences, help explain the remaining gap.
Written for you by our author Sanjukta Mondal, edited by Sadie Harley, and fact-checked and reviewed by Robert Egan—this article is the result of careful human work. We rely on readers like you to keep independent science journalism alive. If this reporting matters to you, please consider a donation (especially monthly). You'll get an ad-free account as a thank-you.
Publication details
Zhuo-Ying Li et al, Disparities in Cancer Incidence by Sex and Associated Lifestyle Factors and Health Conditions, JAMA Oncology (2026). DOI: 10.1001/jamaoncol.2026.3747
Journal information: JAMA Oncology
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OncologyCommon illnesses & PreventionPreventive medicineMen's healthHealthy livingWomen's health Who's behind this story?
Sanjukta Mondal
Master's in Chemistry. Freelance science journalist and communicator. Published in Chemistry World, BioSpace, and The Hindu. Full profile →
Sadie Harley
BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →
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