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The study of biologic differences between sexes has emerged as a distinct scientific discipline. A report from the Institute of Medicine (IOM) found that sex has a broad impact on biologic and disease processes and succinctly concluded that sex matters. The National Institutes of Health established the Office of Research on Womens Health in 1990 to develop an agenda for future research in the field. In parallel, womens health has become a distinct clinical discipline with a focus on disorders that occur disproportionately in women. The integration of womens health into internal medicine and other specialties has been accompanied by novel approaches to health care delivery, including greater attention to patient education and involvement in disease prevention and medical decision-making.


The IOM report recommended the term sex difference to describe biologic processes that differ between males and females and gender difference for features related to social influences. Disorders highlighted here are reviewed in detail in other chapters.


The leading causes of death are the same in women and men: (1) heart disease, (2) cancer (Table 6-1; Fig. 6-1). The leading cause of cancer death, lung cancer, is the same in both sexes. Breast cancer is the second leading cause of cancer death in women, but it causes about 60% fewer deaths than does lung cancer. Men are substantially more likely to die from suicide, homicide, and accidents than are women.

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Table 6-1 Deaths and Percentage of Total Deaths for the Leading Causes of Death by Sex in the United States in 2006
Figure 6-1 Death Rates Per 100,000 Population for 2006 by ...

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