Poor overall survival (OS) in women with advanced bladder cancer, as compared with men with the same disease, may be attributable to the lower frequency of women being treated with systemic chemotherapy, authors of an article in Cancer stated.1

Researchers led by Tracy L. Rose, MD, MPH, of the University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina, identified 23,981 patients diagnosed with stage IV bladder cancer between 1998 and 2010, 35% of whom were female.  Adjusting for the gendered-based difference in likelihood of receiving systemic chemotherapy, the authors found that OS was lower for women than men (hazard ratio for death, 1.11 [95% CI, 1.08-1.15]).

It was concluded that although men with advanced bladder cancer are 7% more likely to be treated with systemic chemotherapy, other unidentified factors, such as unmeasured comorbidities and tumor biology may account for lower OS in women.

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Prior to adjustment, OS was an average of 1.8 months lower for women (8.0 months [95% CI, 7.7-8.3]), than for men (9.8 months [95% CI, 9.5-10.0]), where P < .001. There was no difference in comorbidity score between the 2 groups; women in the cohort, however, were more likely to be older, less likely to be insured, and were more often African-American.


  1. Rose TL, Deal AM, Nielsen ME, Smith AB, Milowsky MI. Sex disparities in use of chemotherapy and survival in patients with advanced bladder cancer [published online ahead of print May 25, 2016]. Cancer. doi: 10.1002/cncr.30029.