title: Gender-related differences in clinical and pathological characteristics and therapy of bladder cancer.
abstract: OBJECTIVE
  To confirm the very high male:female ratios previously observed among Spanish bladder cancer patients and to assess gender differences in tumoral characteristics, diagnostic procedures, and treatment in a large series of consecutive bladder cancer patients.
  
  
  METHODS
  All newly diagnosed bladder cancer patients (n=615) in 17 Spanish hospitals, between 1997-2000, were included. Information was collected both through personal interviews to patients and from medical records using a structured form.
  
  
  RESULTS
  Seventy-six percent of tumours were superficial. The male:female ratio was 6.7 and it was similar for superficial and infiltrating tumours. Women were older than men at the diagnosis of bladder cancer (68.2+/-9.4 years versus 65.7+/-9.7 years, p=0.01). Ten percent of superficial tumours in women, versus 3% in men, were classified as "other histological types" (p=0.008). T1GIII tumours were more frequent among men (17% versus 7%, p=0.047). On the other hand, women were more likely to present with 0a-stage tumours (48.6% versus 35.5%, p=0.04), multiple tumours (50% versus 29%, trend test: 0.005), multi-centric tumours (54% versus 38%, p=0.019), and larger infiltrating masses (5.2 cm versus 3.8 cm, p=0.03) than men. Among 0a-stage tumours, only 23% of women compared to 54% of men received transurethral resection (TUR) alone (p=0.002). Women were almost five-fold more likely to receive additional therapies to TUR (p=0.004) after adjusting for age, geographical area, stage, tumoral size, nuclear grade, and multiplicity.
  
  
  CONCLUSIONS
  The study confirms the very high male:female ratio of bladder cancer in Spain. We found substantial differences in the pathological characteristics of tumours from men and women. There was a tendency for women to receive more frequently non-standard, more aggressive, therapy than men.
authors.affiliation: Institut Municipal d'Investigació Mèdica, Universitat Pompeu Fabra, Carrer del Dr. Aiguader 80, E-08003, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Puente
authors.forename: N
authors.initials: N
authors.lastname: Malats
authors.forename: L
authors.initials: L
authors.lastname: Cecchini
authors.forename: A
authors.initials: A
authors.lastname: Tardón
authors.forename: R
authors.initials: R
authors.lastname: García-Closas
authors.forename: C
authors.initials: C
authors.lastname: Serra
authors.forename: A
authors.initials: A
authors.lastname: Carrato
authors.forename: M
authors.initials: M
authors.lastname: Sala
authors.forename: R
authors.initials: R
authors.lastname: Boixeda
authors.forename: M
authors.initials: M
authors.lastname: Dosemeci
authors.forename: F X
authors.initials: FX
authors.lastname: Real
authors.forename: M
authors.initials: M
authors.lastname: Kogevinas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D012737:Sex Factors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology