The sex difference in tumor incidence is related to the female condition: Models for Europe and Italy

A remarkable aspect of cancer distribution in Europe is the large spatial v ariability of the male-female incidence ratio, from no difference up to 50% . Given the evidence of the predominantly environmental origin of cancer, w e studied the ability of a set of socioeconomic indicators of the female co ndition to model the spatial variability of the sex difference in tumor inc idence at two different scales: between countries (Europe) and between prov inces (Italy). The sex difference in tumor incidence correlated with female socioeconomic condition indicators at the same extent (r = 0.73) in both s ituations, but in opposite directions. In the European study the higher the sexual social equality the lower the differential tumor incidence, whereas the opposite result was shown by the between-provinces Italian study. We a lso investigated the relation of the female condition indicator with other social and cultural descriptors of the same populations, and we suggest exp lanatory models linking female condition and pathology at the continental a nd local scales. Overall, our analysis supports the predominantly environme ntal origin of cancer and stresses the importance of relating cancer patter ns to societal determinants. Our analysis also suggests that the sex differ ence in tumor incidence is a very useful probe for exploring the social-eco nomic cultural correlates of cancer in human populations. We emphasize the need for a thorough analysis of the empirical correlations highlighted in e cologic studies.