title: Sex disparities in melanoma outcomes: the role of biology.
abstract: Melanoma outcomes differ between men and women even when adjusted for prognostic factors such as age, Breslow thickness, body site, ulceration, lymph node dissection, and for treatment, with men having poorer outcomes compared to women. The mechanisms underlying this disparity are not well understood. Behavioral differences between the sexes such as ultraviolet light exposure and health care services utilization have been suggested as contributing, and differences in endogenous biological processes such as immune function, hormonal regulation, oxidative stress response, vitamin D metabolism and sex chromosome gene expression have also been proposed as mechanisms. This review examines the cumulative evidence for biologically based processes that lead to differences in melanoma biology, including inherent sex-based differences in immune function, oxidative stress response and vitamin D metabolism; the complex interplay between sex hormones, the immune system and oxidative stress response; the effect of non-random X chromosome inactivation on tumorigenesis; and the potential contribution of recently identified oncogenes on the Y chromosome.
authors: Dermatology Service, Veterans Affairs Medical Center, San Francisco, CA, United States; Department of Dermatology, University of California, San Francisco, United States.
authors: Adi
authors: A
authors: Nosrati
authors: Dermatology Service, Veterans Affairs Medical Center, San Francisco, CA, United States; Department of Dermatology, University of California, San Francisco, United States. Electronic address: weim@derm.ucsf.edu.
authors: Maria L
authors: ML
authors: Wei
mesh_terms: D041321:Chromosomes, Human, X / Q000235:genetics; D041322:Chromosomes, Human, Y / Q000235:genetics; D005260:Female; D016147:Genes, Tumor Suppressor; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008545:Melanoma / Q000209:etiology* / Q000503:physiopathology; D009857:Oncogenes; D011379:Prognosis; D017382:Reactive Oxygen Species / Q000378:metabolism; D012727:Sex Characteristics; D012878:Skin Neoplasms / Q000209:etiology / Q000503:physiopathology; D014807:Vitamin D / Q000378:metabolism; D049951:X Chromosome Inactivation
chemical_list: D012739:Gonadal Steroid Hormones; D017382:Reactive Oxygen Species; D014807:Vitamin D
keywords: Melanoma; Outcome disparities; Sexual dimorphism