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Gender differences in incidence and outcomes of urothelial and kidney cancer

Nature Reviews Urology volume 12, pages 585–592 (2015)Cite this article

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A Corrigendum to this article was published on 20 October 2015

This article has been updated

Key Points

  • Several studies have reported gender as an independent factor that can influence incidence, recurrence and progression of urological malignancies, but data are inconsistent

  • Men have a threefold higher risk of developing bladder cancer than women

  • Women with bladder cancer are often diagnosed with higher tumour stage and tend to have a worse prognosis than men after adjusting for stage at the diagnosis

  • Men seem to have a higher incidence of upper tract urothelial carcinoma than women; however, survival outcomes might be independent of gender, but data are lacking

  • Men are more frequently diagnosed with renal cell carcinoma than women and also tend to have larger tumours of higher stage and grade

  • Smoking habits, occupational risk factors, tumour biology and sex steroid hormones and their receptors could all have a role in causing the observed gender disparities in patients with urological cancers

Abstract

A gender discrepancy exists in the incidence of both urothelial and kidney carcinomas, with more men presenting with these cancers than women. Men have a threefold greater risk of developing bladder cancer than women, but female gender has been identified as an independent adverse prognostic factor for both recurrence and progression of this disease. In particular, women with bladder cancer are often diagnosed with a higher tumour stage than men. Conclusive data on the influence of gender on outcomes of patients with upper tract urothelial carcinoma are currently lacking, although men seem to have a higher disease incidence, whereas survival outcomes might be independent of gender. Patients with renal cell carcinoma are more often men and they typically have larger tumours and higher stage and grade disease than women with this cancer. Smoking habits, tumour biology, occupational risk factors and sex steroid hormones and their receptors could have a role in these observed gender disparities. The majority of data support the theory that gender influences incidence and prognosis of urothelial and kidney cancers; men and women are different genetically and socially, making the consideration of gender a key factor in the clinical decision-making process. Thus, the inclusion of this variable in validated prognostic tables and nomograms should be discussed as a matter of importance.

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Figure 1: Differences in bladder cancer between genders.
Figure 2: Differences in upper tract urothelial carcinoma between genders.
Figure 3: Differences in renal cell carcinoma (RCC) between genders.
Figure 4: Differences in benign renal tumours between genders.

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Change history

  • 20 October 2015

    In the originally published article, the first line of the section on Bladder cancer epidemiology “Bladder cancer is the fourth most common cancer worldwide” should read “Bladder cancer is the fourth most common cancer in men and the seventeenth most common in women, worldwide”. This error has been corrected for the PDF and HTML versions of the article.

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Acknowledgements

I.L. was supported by the development fund of the CHUV-University Hospital and the European Urological Scholarship Program.

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  1. Department of Urology, Medical University of Vienna, Vienna General Hospital, Währinger Gürtel 18–20, Vienna, A-1090, Austria

    Ilaria Lucca, Tobias Klatte, Harun Fajkovic, Michela de Martino & Shahrokh F. Shariat

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I.L. researched data for and wrote the article, I.L., T.K., M.d.M. and S.F.S. contributed to the discussion of the content and all authors contributed to reviewing and editing the manuscript before submission.

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Lucca, I., Klatte, T., Fajkovic, H. et al. Gender differences in incidence and outcomes of urothelial and kidney cancer. Nat Rev Urol 12, 585–592 (2015). https://doi.org/10.1038/nrurol.2015.232

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