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 U.S. 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 in both women and men. People who were smokers at age 50 could expect to live less years without cancer than people with no risk factors (-4.3 and -6.9 years for women and men) as well as obese (-2.5 and -11.8 years) and physically inactive (-6.5 and -11.2 years). Sex differences decreased at older age. The (co-) occurrence of behavioural risk factors increases the CFLE disadvantage of men compared to women.