{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:17Z","timestamp":1782496517134,"version":"3.54.5"},"reference-count":11,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"unspecified","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Innovation Fund of the Federal Joint Committee","award":["01VSF24051"],"award-info":[{"award-number":["01VSF24051"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,14]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Gastric cancer is the fifth most common cancer globally and the fourth leading cause of cancer-related mortality. While gender and sex differences in gastric cancer care are underexplored in Germany, international studies have revealed disparities in aspects such as histology, comorbidities, treatment approaches and survival outcomes. This study aims to explore gender\/sex-specific variations in clinical management and their impact on mortality, complications and survival rates in gastric carcinoma patients in Germany. The findings may inform revisions to clinical guidelines and support the development of more personalised treatment strategies. This study aims to improve the quality of care for gastric cancer patients and promote more individualised, sex-sensitive medical practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This nationwide, retrospective cohort study will analyse data from the German Diagnosis-Related Groups statistic and regional clinical cancer registries from 2017 to 2021. The study will evaluate both datasets separately, providing a comprehensive view of sex differences in gastric cancer care. Primary outcomes include hospital mortality and survival rates, while secondary endpoints include surgical complications, treatment modalities and postoperative outcomes. The analysis will investigate whether sex influences tumour characteristics, access to treatment and therapy effectiveness. Statistical methods such as descriptive analysis, regression models and survival analysis will be applied to identify sex-related variations in diagnosis, treatment and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study uses anonymised secondary data; thus, ethics approval is not necessary. Findings will be submitted to a peer-reviewed journal, reported to the Innovation Fund of the Federal Joint Committee of Germany, and a patient leaflet for the involved self-help groups will be made.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06902337\">NCT06902337<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103467","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T16:25:32Z","timestamp":1770049532000},"page":"e103467","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Gender differences in gastric cancer care and its adherence to guidelines in Germany (MaGen): protocol for an observational retrospective cohort study with administrative routine and cancer registry data from 2017 to 2021"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct06902337","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5066-3966","authenticated-orcid":false,"given":"Ulrike","family":"Weber","sequence":"first","affiliation":[{"name":"Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6330-832X","authenticated-orcid":false,"given":"Lola","family":"Kre\u00df","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Hunger","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Schildberg","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Mantke","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"2026062610402080000_16.2.e103467.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"2026062610402080000_16.2.e103467.2","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s11377-019-0330-9","article-title":"Gender und Tumoren des oberen Gastrointestinaltrakts","volume":"14","author":"Ott","year":"2019","journal-title":"Gastroenterologe"},{"key":"2026062610402080000_16.2.e103467.3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11377-019-0320-y","article-title":"Geschlechtsspezifische Aspekte in der Viszeralchirurgie","volume":"14","author":"Teegen","year":"2019","journal-title":"Gastroenterologe"},{"key":"2026062610402080000_16.2.e103467.4","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1007\/s11605-019-04304-y","article-title":"Gender Differences in Gastric Cancer Survival: 99,922 Cases Based on the SEER Database","volume":"24","author":"Li","year":"2020","journal-title":"J Gastrointest Surg"},{"key":"2026062610402080000_16.2.e103467.5","doi-asserted-by":"crossref","first-page":"5205","DOI":"10.1007\/s00432-022-04470-8","article-title":"Survival influence of gender on 42,345 patients with gastric cardia adenocarcinoma","volume":"149","author":"Xu","year":"2023","journal-title":"J Cancer Res Clin Oncol"},{"key":"2026062610402080000_16.2.e103467.6","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-021-01225-1"},{"key":"2026062610402080000_16.2.e103467.7","unstructured":"Erdmann F , Spix C , Katalinic A , et al . Krebs in Deutschland f\u00fcr 2017\/2018, 2021. Available: https:\/\/edoc.rki.de\/handle\/176904\/9042 [Accessed 5 Apr 2025]."},{"key":"2026062610402080000_16.2.e103467.8","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1007\/s00761-020-00835-1","article-title":"Epidemiologie des Magenkarzinoms in Deutschland","volume":"26","author":"Hermann","year":"2020","journal-title":"Onkologe"},{"key":"2026062610402080000_16.2.e103467.9","unstructured":"DKR l\u00e4nderatlas. Available: https:\/\/www.dkr.de\/dkr-atlas\/index.html#\/de [Accessed 9 Apr 2025]."},{"key":"2026062610402080000_16.2.e103467.10","first-page":"739","article-title":"Mortality and Complications Following Visceral Surgery: A Nationwide Analysis Based on the Diagnostic Categories Used in German Hospital Invoicing Data","volume":"116","author":"Baum","year":"2019","journal-title":"Dtsch Arzteblatt Int"},{"key":"2026062610402080000_16.2.e103467.11","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15153934","article-title":"Population-Based Clinical Cancer Registration in Germany","volume":"15","author":"Katalinic","year":"2023","journal-title":"Cancers (Basel)"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-103467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:40:51Z","timestamp":1782495651000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-103467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,2]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-103467"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-103467","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}