title: Age-dependent association between sex and renal cell carcinoma mortality: a population-based analysis.
abstract: Research on sex differences in renal cancer-specific mortality (RCSM), which considered the sex effect to be constant throughout life, has yielded conflicting results. This study hypothesized the sex effect may be modified by age, which is a proxy for hormonal status. Data from the Surveillance, Epidemiology and End Results database (1988-2010) were used to identify 114,539 patients with renal cell carcinoma (RCC). The study cohort was divided into three age groups using cutoffs of 42 and 58 years, which represent the premenopausal and postmenopausal periods. The cumulative incidence function and competing risks analyses were used to examine the effect of covariates on RCSM and other-cause mortality (OCM). In premenopausal period, male sex was a significant predictor of poor RCSM for both localized (adjusted subdistribution hazard ratio [aSHR] = 1.63, P = 0.002) and advanced (aSHR = 1.20, P = 0.041) disease. In postmenopausal period, the sex disparity diminished (aSHR = 1.05, P = 0.16) and reversed (aSHR = 0.95, P = 0.017) in localized and advanced disease, respectively. On the contrary, similar trend was not found for OCM across all age groups. Our results demonstrated the sex effect on RCSM was strongly modified by age. These findings may aid in clinical practice and need further evaluation of underlying biological mechanisms.
authors.affiliation: 1] Department of Urology, Fudan University Shanghai Cancer Center, Shanghai. 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai. 200032, China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Qu
authors.affiliation: State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai. 200032, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Chen
authors.affiliation: 1] Department of Urology, Fudan University Shanghai Cancer Center, Shanghai. 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai. 200032, China.
authors.forename: Weijie
authors.initials: W
authors.lastname: Gu
authors.affiliation: 1] Department of Urology, Fudan University Shanghai Cancer Center, Shanghai. 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai. 200032, China.
authors.forename: Chengyuan
authors.initials: C
authors.lastname: Gu
authors.affiliation: 1] Department of Urology, Fudan University Shanghai Cancer Center, Shanghai. 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai. 200032, China.
authors.forename: Hailiang
authors.initials: H
authors.lastname: Zhang
authors.affiliation: 1] State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai. 200032, China [2] Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai. 200032, China [3] Department of Urology, Huashan Hospital, Fudan University, Shanghai. 200032, China [4] Center for Cancer Genomics, Wake Forest School of Medicine, Winston-Salem, NC, U.S.A.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Xu
authors.affiliation: 1] Department of Urology, Fudan University Shanghai Cancer Center, Shanghai. 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai. 200032, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: 1] Department of Urology, Fudan University Shanghai Cancer Center, Shanghai. 200032, China [2] Department of Oncology, Shanghai Medical College, Fudan University, Shanghai. 200032, China.
authors.forename: Dingwei
authors.initials: D
authors.lastname: Ye
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D002423:Cause of Death; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011159:Population Surveillance; D012042:Registries; D012307:Risk Factors; D055815:Young Adult