Women are diagnosed later than men

Written by Abigail Sawyer

Utilizing the entire Danish population as a model, researchers have found a huge gap in the difference between the age of diagnosis for male and female patients across all disease areas.

A study conducted by researchers from the Novo Nordisk Foundation’s Center for Protein Research at the University of Copenhagen (Denmark), has uncovered that on average across all disease areas, women have a later age of diagnosis than men.

“When we look across all diseases, we see a tendency that women on average are diagnosed later than men. We have looked not just at diseases, but also at the course of the patient care. Our study zooms in on the areas where the differences are most pronounced – both for the individual diseases and for the course of the patient care,” explained Soren Brunak, senior author of the paper published in Nature Communications.

“The message is that the national strategies that are established need to take a difference into account. We can no longer use the ‘one size fits all’ model. We are already heading in that direction with respect to personalized medicine.”

The team took data from 6.9 million Danish people and divided them into two groups based on sex. They analyzed disease occurrence, multimorbidity, and course of patient care across the years 1994 – 2015. The results showed that not only are women older when they receive their diagnoses in comparison to men, but also the course of patient care for each sex differs.

They discovered there was an average difference in the age of diagnosis of approximately 4 years. Women received their cancer diagnosis on average 2.5 years later than men, and metabolic diseases, such as diabetes, were diagnosed on average 4.5 years later. In ADHD, there was a difference in diagnosis of 6 years, however, researchers have pointed out that this could be due to ADHD presenting itself differently in females, so is more difficult to diagnose.

An exception was for osteoporosis in which women were diagnosed before they suffered a fracture, however, the opposite is true for men.

The scientists are now moving on to explore the origin of these differences in diagnosis, whether it be genetics, environment, diagnostic criteria, or a combination of these factors. They do believe there is now grounds to take sex into account right from preliminary testing in rats or mice.

“It has been surprising to see that there is such a big difference between the diseases that affect men and women and between their patient care courses in a society where otherwise, we have equal and uniform access to the healthcare system. Now we are trying to map out what really lies behind the differences we see. Can they e.g. be attributed to genetics or environment and culture?” asked first author David Westergaard.

“But we need to think about the fact that there may be a sex difference right from the beginning at the hospitals and in the research. Traditionally, e.g. 50 men and women will be recruited for clinical trials. Afterwards, you look at the overall effect for the test participants. But you forget to make a subanalysis, where you look at the groups separately to see if there are differences. This has only been done during recent years.”