USING data from the U.S. Health and Retirement Study between 2004 and 2020, investigators applied a multistate model to estimate cancer-free life expectancy and years lived with cancer from age 50 onward. They focused on gender differences and how smoking, poor diet, and physical inactivity relate to healthy longevity.
At age 50, women were projected to live 27.3 years cancer-free compared with 24.6 years for men, a difference of 2.7 years. The study also quantified life expectancy with cancer, highlighting that longer overall survival for women does not translate into uniformly better health across the life course. Instead, the gender gap in cancer-free life expectancy reflects both longer survival and differing exposure to behavioral risk factors.
Behavioral Risks Shorten Cancer-Free Years for Women and Men
Smoking, poor diet, and physical inactivity were each associated with fewer cancer-free years in both women and men. Individuals with these risky behaviors transitioned into cancer states earlier and spent less of their remaining life expectancy free of cancer.
Although women started with a higher cancer-free life expectancy, they also lost more cancer-free years than men when exposed to unhealthy behaviors. This pattern suggests that the gender gap in cancer-free life expectancy is sensitive to lifestyle risk profiles and that women may bear a larger burden of lost healthy years when these behaviors are present.
Clinical Implications for Cancer Prevention and Healthy Aging
For clinicians, these findings reinforce the central role of smoking cessation, promotion of physical activity, and support for a healthy diet when counseling adults from age 50 upward. Targeted behavioral interventions could extend cancer-free life expectancy and narrow gender differences in healthy aging.
The authors conclude that gender-sensitive public health strategies are needed to address smoking, poor diet, and physical inactivity in older adults. Integrating routine assessment of these behaviors into primary care and oncology follow-up, and tailoring interventions to the specific needs of women and men, may help increase the number of years patients live free of cancer while also reducing the gender gap in cancer-free life expectancy.
Reference: Feraldi A et al. Gender Gap in Cancer-Free Life Expectancy in the United States: The Association With Smoking, Poor Diet, and Physical Inactivity. Journal of Aging and Health. 2025;doi:10.1177/08982643251404299.
