Sex Gap in Cancer-Free Life Expectancy: The Association with Smoking, Obesity and Physical Inactivity

We measured sex-specific total life expectancy, cancer-free life expectancy (CFLE), and years spent with cancer according to the (co-) occurrence of three behavioural risk factors, such as smoking, obesity and physical inactivity. We examined differences between women and men using data from the United States Health and Retirement Study 2008–2018 and we applied multistate lifetable approach for each combination of smoking, obesity, and physical inactivity, controlling for education. Risk factors were associated with shorter CFLE, the shortest observed in current smoker’s men and women (-4.7 years at age 50). Reductions of CFLE in physically inactive people was higher in women (-3.3 years) than in men (-2.3 years) and obesity had a significant effect only in women (-3.1 years). Sex differences decreased at older age. The (co-) occurrence of behavioural risk factors reduces the CFLE disadvantage of men compared to women.