Sir.—In a recent article entitled "Immunological Bases for Superior Survival of Females" (Journal 133:1251-1253, 1979), Purtilo and Sullivan presented evidence for superior immunocompetence of females and hypothesized that this contributes to the greater longevity of females. It is useful to consider their argument in the context of a more comprehensive analysis of the causes of sex differences in mortality.1
In the contemporary United States, sex differences in mortality due to infectious diseases account for only about 4% of the total sex difference in mortality (based on age-adjusted death rates calculated from data in Vital Statistics of the United States2 using methods described by Waldron1). Sex differences in mortality due to neoplasms account for an additional 14% of the total sex difference in mortality. It is unclear how much of this difference may be due to sex differences in immunocompetence. It should be noted that malignant neoplasms of the
WALDRON I. Mortality and Sex Difference. Am J Dis Child. 1980;134(10):999. doi:https://doi.org/10.1001/archpedi.1980.02130220075027
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