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Sex differences in bladder cancer: understanding biological and clinical implications
Prakash Chaudhary1,2, Biplab Singha1,2, Hany A Abdel-Hafiz2,3
1Department of Medicine and Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Biology of Sex Differences
|May 13, 2025
Summary
Biological sex significantly impacts bladder cancer (BC) risk and outcomes. Understanding sex hormones and chromosomes is crucial for developing personalized BC prevention and treatment strategies.
Area of Science:
- Oncology
- Urology
- Genetics
Background:
- Bladder cancer (BC) presents significant global health disparities, particularly concerning sex and race.
- Urothelial carcinoma (UC) accounts for over 90% of BC cases, exhibiting considerable pathological heterogeneity.
- Molecular subtypes (luminal, basal, neuroendocrine) show distinct genetic and immune profiles.
Purpose of the Study:
- To review the impact of biological sex on bladder cancer incidence, progression, and outcomes.
- To explore the roles of sex hormones and sex chromosomes in BC development.
- To highlight the potential for sex-specific research in improving BC prevention and treatment.
Main Methods:
- Literature review focusing on sex differences in bladder cancer.
- Analysis of molecular subtyping and its relation to sex-based disparities.
- Examination of the influence of androgens, X chromosome, and Y chromosome on BC.
Main Results:
- Androgens increase BC risk via intrinsic and extrinsic mechanisms.
- Sex chromosomes contribute independently and synergistically with hormones to BC sex differences.
- Y chromosome loss is common in BC patients; extra X chromosome offers protection.
Conclusions:
- Biological sex profoundly influences bladder cancer.
- Further research into sex-specific biology is essential for personalized BC prevention and care.
- Advanced technologies like multiomics and AI can enhance understanding of sex differences in BC.
