Open AccessMechanism of Sex Differences in Bladder Cancer: Evident and Elusive Sex-biasing Factors
Author(s) -
Christa M. Lam,
Zihai Li,
Dan Theodorescu,
Xue Li
Publication year - 2022
Publication title -
bladder cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.27
H-Index - 19
eISSN - 2352-3735
pISSN - 2352-3727
DOI - 10.3233/blc-211658
Subject(s) - epigenetics , mechanism (biology) , biology , gender bias , bladder cancer , cancer , genetics , gene , psychology , social psychology , philosophy , epistemology
Bladder cancer incidence is drastically higher in males than females across geographical, racial, and socioeconomic strata. Despite potential differences in tumor biology, however, male and female bladder cancer patients are still clinically managed in highly similar ways. While sex hormones and sex chromosomes have been shown to promote observed sex differences, a more complex story lies beneath these evident sex-biasing factors than previously appreciated. Advances in genomic technology have spurred numerous preclinical studies characterizing elusive sex-biasing factors such as epigenetics, X chromosome inactivation escape genes, single nucleotide polymorphism, transcription regulation, metabolism, immunity, and many more. Sex-biasing effects, if properly understood, can be leveraged by future efforts in precision medicine based on a patient's biological sex. In this review, we will highlight key findings from the last half century that demystify the intricate ways in which sex-specific biology contribute to differences in pathogenesis as well as discuss future research directions.