Gender Gap in Cancer-Free Life Expectancy in the United States: The Association With Smoking, Poor Diet, and Physical Inactivity

Background While life expectancy has increased globally, chronic disease burdens remain high. Cancer, despite improved survival, remains a major cause of disability and the second leading cause of death. Though behavioral risks such as smoking, poor diet, and physical inactivity are linked to cancer, few studies examine their impact on cancer-free life expectancy and gender disparities. Methods Using U.S. Health and Retirement Study data (2004-2020) and a multistate model approach, we estimated cancer-free life expectancy and life expectancy in individuals with cancer at age 50+, examining gender differences and their associations with smoking, poor diet, and physical inactivity. Results At age 50, women live 2.7 more years cancer-free than men (27.3 vs. 24.6 years). Risky behaviors reduce cancer-free life expectancy in both sexes, but women lose more years than men. Conclusions Gender-sensitive public health strategies targeting healthy behaviors could extend cancer-free life expectancy and reduce gender gaps in aging populations.