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Background <p>Males have a higher incidence of cancers at shared anatomic sites than females. We investigated whether sex differences in cancer incidence differed across race/ethnicity.</p> Methods <p>Within 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.</p> Results <p>Of 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; <i>P</i> = 0.018), liver (Japanese American 1.28, 0.96–1.70; White 2.79, 1.81–4.30, <i>P</i> = 0.005) and thyroid (Latino 0.21, 0.13–0.35; White 0.83, 0.50–1.37, <i>P</i> = 0.005). Cancer risk factors explained 82% of the overall sex difference observed for lung cancer but 0% of the difference for gallbladder cancer.</p> Discussion <p>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.</p>

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Sex differences in cancer incidence persist across race and ethnicity

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月28日

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  • Julia J. Francis,
  • Hormuzd A. Katki,
  • Barry I. Graubard,
  • Christopher A. Haiman,
  • Loïc Le Marchand,
  • Veronica Wendy Setiawan,
  • Lynne R Wilkens,
  • Anil Chaturvedi,
  • Sarah S. Jackson

摘要

Background

Males have a higher incidence of cancers at shared anatomic sites than females. We investigated whether sex differences in cancer incidence differed across race/ethnicity.

Methods

Within 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.

Results

Of 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.