Gender Differences in Bladder Cancer

Is bladder cancer gender dimorphic?

  • Only 25% of bladder cancer (BCa) patients are female, males are 3-4X more likely to develop BCa.
  • While women have a lower risk of developing BCa, BCa is often more aggressive in women. Compared to men, bladder cancer-specific survival for women is 50% lower at every stage4.
  • The cause of the gender differences in incidence and aggressiveness of BCa is not known.
  • Epidemiologic associations have also identified hormonal status related to menopause as a risk factor to develop BCa in women; the median age of diagnosis for women with BCa is 68 years, and most women are post-menopausal.
  • Conversely, early menopause in women is associated with a 30-40% increased risk of developing BCa cancer
  • This suggests that hormonally regulated differences in tumor initiation may prevent bladder cancer in younger women but are associated with worse outcomes in postmenopausal women.

We hypothesize that the lower incidence of BCa in pre- menopausal females is secondary to differential carcinogen metabolism regulated by nuclear hormone receptors that prevent the activation of the inflammasome and pro-inflammatory immune cascade in females