Sex Differences in Onset and Prevalence of 108 Diseases and Multimorbidity Across Lifespan in China: Quantitative Analysis of Real-World Linked Electronic Health Records
Author(s)
Yueqing Wang, MPH, Enying Gong, PhD.
School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
School of Population Medicine and Public Health, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
OBJECTIVES: To comprehensively examine sex differences in the onset and progression of 108 major physical and mental diseases to multimorbidity through adulthood in China.
METHODS: We leveraged integrated electronic health records from 160 healthcare facilities in Yichang, China. The analysis included all urban residents aged 20 years and above with documented health records between Jan 1, 2016 and Dec 31, 2019. We calculated the cumulative incidence and period prevalence of 108 diseases across different age groups and assessed the relative risks (RR) of top prevalent diseases between sexes. We also compared the median age at disease diagnosis and the prevalence of multimorbidity between females and males.
RESULTS: The analysis included 684 455 individuals (54.8% females, mean age: 46.9), among whom 46.3% had multimorbidity, with a higher prevalence in females (47.6%) than males (44.9%). The chronological disease map revealed stark differences between females and males, with notable lower risk of obstructive sleep apnea-hypopnea syndrome (OSAHS, RR: 0.03, 95% CI: 0.01 to 0.11) for young adults, esophageal cancer (RR: 0.02, 95% CI: 0.0 to 0.17) for mid-age adults, and remarkable higher risk of lupus (RR: 8.8, 95% CI: 2.7 to 29.0) for older adults of females. Males exhibited an incidence surge in hypertension, diabetes, coronary disease, and chronic obstructive pulmonary disease (COPD) a decade earlier than females, while females had a life-long higher prevalence in immune-mediated diseases and urinary disorders. For the new incident diseases, the manifestation of eating disorders, anemia and urinary incontinence were recorded 20 years earlier in females, whereas males were diagnosed with hyperuricemia, OSAHS and schizophrenia at younger ages.
CONCLUSIONS: The significant variations in disease nature and trajectory between sexes underscore the urgent needs for tailored prevention strategies and appropriate health resources allocation. Sex differences in disease profile should be considered to delay disease and multimorbidity progression, ultimately promoting health equity.
METHODS: We leveraged integrated electronic health records from 160 healthcare facilities in Yichang, China. The analysis included all urban residents aged 20 years and above with documented health records between Jan 1, 2016 and Dec 31, 2019. We calculated the cumulative incidence and period prevalence of 108 diseases across different age groups and assessed the relative risks (RR) of top prevalent diseases between sexes. We also compared the median age at disease diagnosis and the prevalence of multimorbidity between females and males.
RESULTS: The analysis included 684 455 individuals (54.8% females, mean age: 46.9), among whom 46.3% had multimorbidity, with a higher prevalence in females (47.6%) than males (44.9%). The chronological disease map revealed stark differences between females and males, with notable lower risk of obstructive sleep apnea-hypopnea syndrome (OSAHS, RR: 0.03, 95% CI: 0.01 to 0.11) for young adults, esophageal cancer (RR: 0.02, 95% CI: 0.0 to 0.17) for mid-age adults, and remarkable higher risk of lupus (RR: 8.8, 95% CI: 2.7 to 29.0) for older adults of females. Males exhibited an incidence surge in hypertension, diabetes, coronary disease, and chronic obstructive pulmonary disease (COPD) a decade earlier than females, while females had a life-long higher prevalence in immune-mediated diseases and urinary disorders. For the new incident diseases, the manifestation of eating disorders, anemia and urinary incontinence were recorded 20 years earlier in females, whereas males were diagnosed with hyperuricemia, OSAHS and schizophrenia at younger ages.
CONCLUSIONS: The significant variations in disease nature and trajectory between sexes underscore the urgent needs for tailored prevention strategies and appropriate health resources allocation. Sex differences in disease profile should be considered to delay disease and multimorbidity progression, ultimately promoting health equity.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD136
Topic Subcategory
Health & Insurance Records Systems
Disease
STA: Personalized & Precision Medicine