TABLE 1

Differences in the epidemiology, outcomes and treatment of chronic lung diseases

DiseaseEpidemiologyPhenotype/prognosisTreatment
AsthmaChildhood boys >girls
Adulthood females >males
Severe asthma females >males
Females have more non-allergic asthma
Higher frequency of hospitalisation in females
Worse quality of life in females
Females may have more Th2 low disease
Bronchiectasis∼70% female globallyMales have worse lung function and more severe disease
Worse symptoms, increased cough in females
High frequency of P. aeruginosa and NTM in females
No sex-related differences Increased awareness of NTM in females
COPDClassically male disease but prevalence increasing in females
Diagnostic bias in favour of males
Females have more small airways disease, less emphysema, worse quality of life, more anxiety and depression and more rapid lung function declineNo sex-related differences in treatment
CFEqual disease prevalence (genetic)
Diagnostic bias in favour of males
Decreased survival in females
Greater rate of pulmonary exacerbations (post-puberty)
Earlier acquisition of P. aeruginosa in females (and greater lung function decline)
Worse quality of life, greater depression in females
Discouragement of treatment, acceptance of being underweight in young females
IPFGreater prevalence in malesImproved post-transplant outcomes, survival in females
Greater symptom burden and worse health-related quality of life in females
No data
PAHGreater prevalence in femalesDecreased survival in males (“oestrogen paradox”)Sex-related differences in response to commonly used therapies
SBDGreater prevalence in males; middle-aged men thought to be most vulnerable
Diagnostic bias in favour of males
Differing symptoms between males and females
Greater severity in males
Susceptibility may increase in females with obesity, pregnancy, menopause; maternal SBD may impact neonatal outcomes
No data

COPD: chronic obstructive pulmonary disease; CF: cystic fibrosis; IPF: interstitial pulmonary fibrosis; NTM: non-tuberculous mycobacteria; P. aeruginosa: Pseudomonas aeruginosa; PAH: pulmonary arterial hypertension; SBD: sleep-related breathing disorders.