Gender Differences in Gastric Cancer Care and Its Adherence to Guidelines in Germany: A Observational Retrospective Cohort Study With Administrative Routine and Cancer Registry Data From 2017-2021

Gastric cancer is the fifth most common cancer globally and the fourth leading cause of cancer-related mortality. While there is a lack of current data on gender differences in gastric cancer care in Germany, several international studies conducted on the basis of clinical cancer registry data have pointed to the relevance of this aspect in recent years. The analyses showed significant differences between women and men in aspects such as histology, co-morbidities, operations and therapies performed, and survival rates.

In Germany in 2017, 15,690 people were diagnosed with gastric cancer, of which 6190 were women (39%) and 9490 men (61%). The age-standardized rate of new cases is 7.8 for women and 14.9 for men. The risk of developing the disease increases with age in both sexes; men develop stomach cancer on average at the age of 71 and women at 76 years of age. There are regional differences between the federal states of Germany in all key figures. For example, in the state of Bavaria in 2019, both sexes have an above-average 5-year survival rate of 46.1% for men and 50.7% for women, while in the state of Brandenburg there is a large difference in this ratio between men (38.5%) and women (46.0%).

With regard to hospital mortality in Germany, an analysis of data from the DRG statistics for the years 2009 -2015 showed that the highest mortality rate of 11.7% was observed in patients undergoing visceral surgery in complex gastric surgery (in comparison, average hospital mortality among patients undergoing visceral surgery: 1.9%).

The aim of the project is to use routine data of the DRG statistic and data from the clinical cancer registries of the federal states to determine whether there are differences between women and men in the clinical care of gastric carcinomas and whether such different care has an impact on the mortality rate, complications and survival time of those affected.

Data from the hospital statistics (DRG statistics) and data from the clinical cancer registries are used as the data basis for the above-mentioned research questions and evaluated separately from each other.