ArticleBiology of sex differences2026
Sex differences in cancer incidence persist across race and ethnicity.
Article in Biology of sex differences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMales have a higher incidence of cancers at shared anatomic sites than females. We investigated whether sex differences in cancer incidence differed across race/ethnicity.
methodsWithin the Multiethnic Cohort Study, we examined the association between sex and cancer incidence at 13 shared anatomic sites using Cox proportional hazards regression to estimate male-to-female hazard ratios (MF HRs) adjusting for cancer specific risk factors by race/ethnic group: African American, Japanese American, Native Hawaiian, Latino, and White. Statistical differences in the MF HRs by race/ethnicity for each site were assessed with an interaction term. The percentage of sex difference in cancer incidence that was statistically explained by the risk factors within race/ethnicity were quantified using a Peters-Belson approach.
resultsOf the 178,036 participants, 46% were male and 54% were female. Adjusting for multiple risk factors did not eliminate the MF differences for any of the cancers examined. We found significant differences in MF HRs across race/ethnicity for cancers of the esophagus (Native Hawaiian MF HR 17.67, 95% CI 2.21-141.20; African American 1.28 0.69-2.36; P = 0.018), liver (Japanese American 1.28, 0.96-1.70; White 2.79, 1.81-4.30, P = 0.005) and thyroid (Latino 0.21, 0.13-0.35; White 0.83, 0.50-1.37, P = 0.005). Cancer risk factors explained 82% of the overall sex difference observed for lung cancer but 0% of the difference for gallbladder cancer. DISCUSSION: Most non-sex-specific cancers have male predominance across race/ethnicity, which are not fully explained by cancer risk factors, suggesting there may be intrinsic sex differences driving these differences in cancer incidence.
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