Gender Differences In Incidence Research Articles

Laryngeal Cancer in Women: Unveiling Gender-Specific Risk Factors, Treatment Challenges, and Survival Disparities.

Laryngeal cancer is one of the main causes of morbidity and mortality worldwide, with a significantly higher prevalence among men than women. However, the incidence, clinical characteristics, and specific treatment of laryngeal cancer in women have often been overlooked by research. This review aims to examine gender differences in incidence, risk factors, hormonal mechanisms, survival, and therapeutic approaches for laryngeal cancer in women. Although smoking and alcohol remain the main risk factors, evidence suggests that women may be more vulnerable to the harmful effects of these behaviors, with a relative higher risk than men. In addition, hormonal factors such as estrogen may influence women's susceptibility to laryngeal cancer, accelerating tumor growth and complicating treatment. Differences in treatment between the sexes, with women tending to receive less intensive treatment than men, is another crucial aspect that needs more attention. This article also analyses the disparities in survival, highlighting that women often have a better prognosis, although this trend varies according to demographic characteristics and the health system. The increasing incidence of laryngeal cancer in women requires increased research to fully understand risk factors and underlying biological mechanisms in order to develop more personalized treatments and optimize clinical outcomes for patients.

Gender-Related Difference in Skin Oxygenation in Young Patients with Uncomplicated Type 1 Diabetes.

Gender, through genetic, epigenetic and hormonal regulation, is an important modifier of the physiological mechanisms and clinical course of diseases. In diabetes mellitus, there are gender differences in incidence, prevalence, morbidity, and mortality. This disease also has an impact on the microvascular function. Therefore, this cross-sectional study was designed to investigate how gender affects the cutaneous microcirculation. We hypothesized that gender should be an important factor in the interpretation of capillaroscopy and transcutaneous oxygen saturation results. The study group consisted of 42 boys and 55 girls, uncomplicated diabetic pediatric patients. Females (F) and males (M) did not differ in terms of age, age at onset of diabetes, or diabetes duration. Furthermore, they did not differ in metabolic parameters. The comparison showed that group F had lower BP, higher pulse, and higher HR than group M. Group F had significantly lower creatinine and hemoglobin levels than group M. In children and adolescents with type 1 diabetes without complications, there was a gender difference in microcirculatory parameters. The resting transcutaneous partial pressure of oxygen was significantly higher in females than in males. However, there were no gender-related differences in basal capillaroscopic parameters or vascular reactivity during the PORH test. Our results indicate that studies investigating the structure and function of the microcirculation should consider the role of gender in addition to known cofactors such as puberty, body mass index, physical activity, and cigarette smoking.

The influence of gender on the epidemiology of and outcome from sepsis associated acute kidney injury in ICU: a retrospective propensity-matched cohort study

PurposesThe influence of gender on the epidemiology of and outcome from SA-AKI in ICU has not been fully clarified. Our aim is to elucidate these differences.MethodsThis study included adult patients with sepsis in MIMIC IV (V 2.2), and propensity matching analysis, cox regression and logistic regression were used to analyze gender differences in incidence, mortality and organ support rate.ResultsOf the 24,467 patients included in the cohort, 18,128 were retained after propensity score matching. In the matched cohort, the incidence of SA-AKI in males is higher than that in females (58.6% vs. 56.2%; P = 0.001).males were associated with a higher risk of SA-AKI (OR:1.07(1.01–1.14), P = 0.026;adjusted OR:1.07(1.01–1.14), P < 0.033).In SA-AKI patients, males were associated with a lower risk of ICU mortality(HR:0.803(0.721–0.893), P < 0.001;adjusted HR:0.836(0.746–0.937), P = 0.002) and in-hospital mortality(HR: 0.820(0.748–0.899), P < 0.001;adjusted HR:0.853(0.775–0.938), P = 0.003).there were no statistically significant differences between male and female patients in 1-year all-cause mortality (36.9% vs. 35.8%, P = 0.12), kidney replacement therapy rate (7.8% vs.7.4%, P = 0.547), mechanical ventilation rate 64.8% vs.63.9%, P = 0.369), and usage of vasoactive drugs (55.4% vs. 54.6%, P = 0.418).ConclusionsGender may affect the incidence and outcomes of SA-AKI, further research is needed to fully understand the impact of gender on SA-AKI patients.

Knee osteoarthritis patients assessed during walking for ankle inversion movement discrimination sensitivity.

Background: Knee osteoarthritis (KOA) is a common musculoskeletal condition that affects dynamic balance control and increases the risk of falling during walking. However, the mechanisms underlying this are still unclear. Diminished ankle proprioception during walking has been found to be related to fear of falling in older adults, with a gender difference in incidence of falling. This study aimed to determine 1) whether ankle inversion proprioceptive acuity during walking is impaired in patients with KOA; and 2) whether there is any difference between genders. Methods: Thirty-two patients with KOA (F:M = 17:15, Median age = 52.5, BMI = 22.3 ± 3.0) and 34 healthy controls without KOA (HC) (F:M = 17:17; median age = 49.0, BMI = 22.5 ± 2.7) were recruited. In patients with KOA, ankle inversion proprioceptive acuity was measured on the affected side using the ankle inversion discrimination apparatus for walking (AIDAW), whilst HC were assessed on a randomly selected side. Two-way (2*2) analysis of variance (ANOVA) was performed to determine the main effects and interaction between gender and KOA condition. Results: Two-way ANOVA showed a significant KOA main effect (F = 26.6, p < 0.001, ƞp 2 = 0.3) whereby AIDAW scores during walking for individuals with KOA were significantly lower than those without KOA (KOA vs. HC: 0.746 ± 0.057 vs. 0.807 ± 0.035). There was neither a gender main effect nor interaction (both p > 0.05). Conclusion: Individuals with KOA demonstrated lower ankle proprioception scores during walking compared to their healthy counterparts, with a similar level of impairment in ankle proprioceptive acuity between male and female patients. A low score may contribute to an increased risk of falling in the KOA population. The current findings suggest the need for global concern about lower limb proprioception in the clinical management of KOA.

Gender differences in tumor characteristics, treatment and survival of colorectal cancer: A population-based study

BackgroundThe importance of sex and gender as modifiers of health and disease is increasingly recognized. The aim of this study was to analyze gender differences in incidence, tumor characteristics, treatment and relative survival (RS) in colorectal cancer (CRC). MethodsObservational population-based study including patients diagnosed with CRC in the Netherlands between 2010 and 2020. Stratified by localization (colon/rectum) and age (18–55/56–70/≥71years), gender differences in incidence, tumor characteristics, treatment and RS were analyzed. Multivariable regression was used to analyze the influence of gender on treatment and RS. ResultsThe age-standardized incidence per 100,000 person-years of colon and rectal cancer is higher among men than women (colon: 41.2 versus 32.4, rectum: 22.8 versus 12.6). Besides differences in patient- and tumor characteristics, differences in treatment allocation and RS were observed. Most strikingly, women aged ≥ 71 years with stage IV colon cancer are less often treated with systemic therapy (31.3 % versus 28.4 %, adjusted odds ratio (OR) 0.63, 95 % CI 0.48–0.83) and more often receive best supportive care only (47.6 % versus 40.0 %, adjusted OR 1.58, 95 % CI 1.19–2.11). ConclusionStatistically significant and clinically relevant gender differences in incidence, patient- and tumor characteristics and treatment allocation are observed in patients with CRC. Reasons for differences in treatment allocation deserve further investigation.

Bladder paraganglioma, gastrointestinal stromal tumor, and SDHB germline mutation in a patient with Carney-Stratakis syndrome: A case report and literature review.

Carney-Stratakis syndrome (CSS) is a rare dyad of paraganglioma (PGL)/pheochromocytoma (PHEO) and gastrointestinal stromal tumor (GIST). PGLs are neuroendocrine tumors of neural crest origin which are mostly found in the head, neck, and retroperitoneal space. GISTs are the most common mesenchymal tumors of the digestive tract, usually caused by KIT/PDGFRA mutations. Here, we reported a case of CSS with unusual bladder PGL and succinate dehydrogenase (SDH) deficient GIST due to a germline mutation in SDH-subunit B (SDHB) gene. A 39-year-old female patient initially diagnosed with gastric GIST and isolated pelvic metastasis was eventually found to be CSS with bladder PGL and SDH-deficient GIST after surgery. This patient underwent resection of gastric and bladder tumors, and postoperative pathology confirmed the diagnosis of CSS. According to the next-generation sequencing (NGS), the patient carried a germline mutation in the SDHB gene, which was the cause of the disorder. The patient had no tumor recurrence with regular follow-up in 10 months. CSS is an autosomal genetic disorder with no gender difference in incidence, and PGLs are more frequent than GISTs. SDH germline mutation is the molecular biological mechanism of CSS while the most common type is SDHB mutation. The unique mechanism of tumorigenesis including hypoxia and hypermethylation caused by SDH deficiency renders target therapy with tyrosine kinase inhibitors ineffective, therefore complete surgical resection is the optimal treatment in the absence of tumor metastases.

Gender differences in the incidence of systemic lupus erythematosus in Norway: a population-based cohort study

<h2>Abstract</h2><h3>Background</h3> Norway is one of the few countries worldwide where societal factors facilitate complete population-based cohorts on rare diseases. We aimed to estimate gender differences in the annual incidence of systemic lupus erythematosus in South-East Norway (population 2·9 million). <h3>Methods</h3> This population-based cohort study was done using databases from 12 public hospitals in South-East Norway. We identified participants on the basis of a diagnosis with systemic lupus erythematosus (ICD-10 code M32), chart reviews, and recorded demographic and clinical parameters. Participants with clinical systemic lupus erythematosus who met the 1997 American College of Rheumatology (ACR) classification criteria were included. We looked for secular trends by dividing the cohort into two decades (1999–2007 and 2008–2017) and stratified by age and gender. We defined gender in accordance with the Norwegian social security number, which defines individuals as female or male. Time trend analysis was estimated using the χ² test. <h3>Findings</h3> Between Jan 1, 1999, and Dec 31, 2017, records for 3490 individuals were extracted. 1558 (44·6%) of 3490 had a systemic lupus erythematosus diagnosis in their medical record. The 1997 ACR criteria were met by 1300 (83·4%) of 1558 people, and 673 (51·8%) of those 1300 were diagnosed between 1999–2017. The median age of participants was 38 years (IQR 25–49). The peak incidence rate was 4·3 per 100 000 women aged 20–29 years and 0·6 per 100 000 men aged 40–69 years. The average incidence rate of systemic lupus erythematosus in children and adolescents (defined as disease onset at age 15 years or younger) was stable at 0·3 for during 1999–2007 and 0·4 during 2008–2017. The average incidence rate for adult-onset systemic lupus erythematosus (defined as disease onset at age 16 years or older) in 1999–2017 was 1·6 per 100 000 people (2·7 per 100 000 women and 0·5 per 100 000 men). The incidence rate for 1999–2007 was 3·0 per 100 000 women and 0·6 per 100 000 men. The incidence rate in 2008–2017 was 2·4 per 100 000 women and 0·4 per 100 000 men. Women aged 50–59 years had a significant reduction in annual incidence from 3·0 per 100 000 during 1999–2007 to 1·3 per 100 000 during 2008–2017 (p=0·0007). The overall incidence rate for adults, children, and adolescents showed a significant decline during 1999–2017 from 1·85 to 1·13 per 100 000 (p=0·0036). The decline for women was from 3·08 to 2·13 per 100 000 (p=0·033) and for men was from 0·58 to 0·14 per 100 000 (p=0·033). Women aged 50–59 years also showed a significant decline in annual incidence during 1999–2017 from 3·39 to 1·07 per 100 000 women aged 50–59 years (p=0·0031). <h3>Interpretation</h3> We found decreasing incidence of systemic lupus erythematosus during 1999–2017, which was most pronounced in women aged 50–59 years. This finding might be due to the reduction of hormone replacement therapy in this timeframe. <h3>Funding</h3> The Norwegian Women's Public Health Association, The DAM Foundation, Vivi Irene Hansens Foundation, and the Norwegian Rheumatism Association.

Multi-Center Study on Gender Difference in Resectability and Pathologic Prognosis of Gallbladder Cancer

Background/Aim: In gallbladder cancer (GBC), gender differences in incidence and mortality rates have been reported with geographic variation. However, there is little known about sex-related difference in GBC prognosis. This study compares prognostic factors according to gender for GBC.Methods: We searched clinicopathological factors in all stages of 952 GBC patients from seven medical centers in Korea. A total of 927 patients were enrolled and surgery with curative resection was performed in 499 patients.Results: Carbohydrate antigen (≥37 U/mL) was a significant prognostic factor in both females and males (odd ratio [OR], 4.30; 95% confidence interval [CI], 3.13-5.89; p&lt;0.001). Age was a significant factor only in female patients, elderly patients were associated with low resectability and the likelihood of T-stage &gt;2; an independent predictor of poor prognosis via multivariate analysis (OR, 1.03; 95% CI, 1.01-1.05; p=0.005, OR, 1.05; 95% CI, 1.02-1.08; p=0.002). Body mass index (BMI) also showed gender difference, and lower BMI (≤25 kg/m&lt;sup&gt;2&lt;/sup&gt;) was the significant good indicator of multivariate analysis for lymph node metastasis in female patients (OR, 0.42; 95% CI, 0.23-0.77; p=0.005) but, the significant poor indicator of univariate analysis for advanced T-stage in male (OR, 2.79; 95% CI, 1.40-5.54; p=0.003).Conclusions: These results suggest that there is a possibility of gender difference in GBC prognosis. Age and high BMI were poor prognostic factors for curative resection for female GBC patients.

Gender Differences in Incidence of Type 2 Diabetes and Related Psychosocial Factors

Introduction: Diabetes is one of the chronic diseases which causes other chronic diseases. The incidence of it is increasing in different societies, including Iran. This study aimed to investigate Gender differences in incidence of type 2 diabetes and related psychosocial factors. Methods: This was a cross-sectional study conducted in 2019 among people with the age group of 20 to 60. All the 600 participants were married and lived in Kerman. Using multi-stage sampling, 300 men and 300 women were selected. Data were collected through a questionnaire which included 3 sections as follows: Social demographic variables, healthy lifestyle variabl and perceived stress variable. Statistical analysis was done through descriptive statistics, Lambda test, Independent sample T -test and Binary Logistic regression. The SPSS 23 was used to perform the data analysis. The significance level of the study was considered to be p=0.05. Results: The mean (SD) score of physical activity for women was significantly lower than men: (7.6 (2.3) vs. 8.2 (2.7) (P=0.006) ). In the same vein, the mean (SD) score of healthy diet among women was significantly higher than men: (18.6 (3) vs. 18 (2.4),( P&lt;0.001) ). The rate of avoidance of tobacco and alcohol consumption among women was significantly higher than men: (19.4 (1.3) vs. 17.9 (2.6),( P&lt;0.001) ). Results of multiple logistic regression showed that in the group of women, the chance of developing diabetes was significantly related to perceived stress level (OR=1.21), level of sports activities OR=0.48) (and education. Education level and health diet also had a significant effect on men's odds of developing diabetes (OR=0.63, 1.35, respectively). Conclusion: Among the indicators of healthy lifestyle, doing exercise in women and having a healthy diet in men were effective in predicting the risk of diabetes. In addition, the amount of perceived social stress was one of the most important psychological factors in the development of diabetes just in women. Therefore, it is crucial to recognize the factors affecting diabetes in both men and women separately and This can be an appropriate analytical instrument for sociologists and health researchers to recognize and focus on this problem as well as for health policy makers to reduce and control harmful factors.

1194-P: Gender Differences in Incidence of Prediabetes and Diabetes in South Asians

Background: Among South Asians, women have higher prevalence of diabetes than men, but few studies have examined gender differences in incidence. Methods: We analyzed data from 2714 adults aged ≥20 years, enrolled in the Chennai site of prospective Cardiometabolic risk reduction in South Asia (CARRS) study. We defined normal glucose tolerance (NGT) , isolated impaired fasting glucose (iIFG) , impaired glucose tolerance (IGT) , and diabetes based on ADA criteria. We estimated incidence densities for: NGT (n=2205) to iIFG and iIFG (n=641) to diabetes; NGT (n=2205) to IGT; and IGT (n=341) to diabetes. Results: Prevalence of iIFG was higher in women (20.5% vs. 11.8%) , while prevalence of IGT was lower (6.6% vs. 8.5%) than in men. During median 2.6 y (IQR: 0.7, 5.8) of follow-up, 316 individuals progressed from NGT to iIFG, 239 from NGT to IGT, 155 from iIFG to diabetes, and 135 from IGT to diabetes. Overall, incidence (95% CI) of NGT to iIFG was higher than incidence of NGT to IGT (36.3 [32.5, 40.5] vs. 27.4 [24.1, 31.1] per 1,000 person-years [PYR], respectively) . However, the incidence of iIFG to diabetes was lower than incidence of IGT to diabetes (47.3 [40.4, 55.4] vs. 77.1 [65.1, 91.3] per 1,000 PYR, respectively) . Compared with men, women had higher conversion from NGT to iIFG (42.1 [36.9, 48] vs. 27.7 [22.7, 33.8]) , but lower incidence of NGT to IGT, 22.9 (19.2, 27.4) vs. 34.2 (28.5, 40.9) . Women had higher conversation both from iIFG to diabetes [49.0 (40.8,58.8) vs. 43.1 (31.6,58.7) ] and IGT to diabetes (87.7 [70.5,109.0] vs. 65.3 [50.0,85.2]) . In Cox models adjusting for age, BMI and family history of diabetes, women were 1.41 times (95% CI: 1.07,1.84) likely to convert from NGT to iIFG compared to men, but, men are 1.76 (1.33, 2.34) times at risk from NGT to IGT. There was no gender difference for conversion from iIFG or IGT to diabetes. Conclusion: Prevalence and incidence of iIFG is higher in South Asian women than men, while prevalence and incidence of IGT is higher in men. Conversion from iIFG or IGT to diabetes is similar among genders. Disclosure K.Narayan: n/a. H.H.Chang: None. N.Tandon: None. V.Mohan: None. D.Kondal: None. L.R.Staimez: None. R.Anjana: None. U.Gujral: None. M.Deepa: None. S.A.Patel: Research Support; Johnson &amp; Johnson. M.K.Ali: Advisory Panel; Bayer AG, Research Support; Merck &amp; Co., Inc. D.Prabhakaran: None. Funding The National Heart, Lung, and Blood Institute (NHLBI) , National Institutes of Health (HHSN268200900026C)

Gender differences in prevalence and risk factors of sleep disturbances in patients with epilepsy

BackgroundSleep disturbances are frequently observed in patients with epilepsy (PWE), with adversely effects on life quality and seizure control. The study aimed to assess the gender differences in incidence and factors of sleep disturbances in PWE.MethodsPWE confirmed the diagnosis of epilepsy were consecutively enrolled in this cross-sectional study, with detailed information recorded. A group of healthy participants were recruited as the control. Sleep and mood disorders were evaluated with the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI).ResultsOne hundred and thirty-three patients (age: 30.2 ± 10.6 years, men: 51%) and 150 healthy subjects were recruited in this study. Compared with healthy controls, PWE had higher mean scores of the ISI and BDI (p < 0.001 and p = 0.01). There were no significant gender differences in the prevalence and scores of sleep disturbances in PWE. In the overall PWE, nocturnal seizures and focal epilepsy were respectively related to insomnia and poor sleep quality (OR = 3.35, p = 0.024; OR = 3.08, p = 0.013), and mood disorders were also important factors in sleep disturbances (p < 0.05). In the analysis by gender, depression, anxiety, nocturnal seizures and focal epilepsy were associated with insomnia and poor sleep quality in men. For women, however, depression mood was the only factor of sleep disturbances.ConclusionsThough no gender difference was observed in the incidence of sleep disturbances, factors contributing to insomnia and sleep quality were different by gender. The factors and gender differences of sleep disturbances should be taken into account in the clinical treatment.

MO484: Gender Differences in the Incidence of End-Stage of Renal Disease in Okinawa

Abstract BACKGROUND AND AIMS The incidence of chronic kidney disease (CKD) and its progression to end-stage renal disease (ESRD) differ between genders, so it can be surmised that the incidence of ESRD is different between males and females. Acceptance of dialysis therapy may not necessarily be equal to the incidence of ESRD. Factors such as socio-economic conditions of the family, residential area, risk factors and compliance to the treatment of CKD are not equal among gender. We accessed the gender difference in incidence of ESRD and its risk factors in Okinawa, Japan, a major ESRD epidemic area. METHOD The Okinawa Dialysis Study (OKIDS) registry included all chronic dialysis patients treated in Okinawa, Japan, since 1971. We defined the ESRD as those who survived at least one month on scheduled dialysis therapy (hemodialysis and peritoneal dialysis) to exclude acute kidney injury. We analyzed the annual incidence of ESRD by gender for 30 years from 1971 to 2000. The incidence rate of ESRD was calculated as the number of incident dialysis patients divided by the census population of the previous year in each gender and expressed per million population (pmp). The number of dialysis facilities increased from 1 (1971) to 50 (2000). The census population was increased from 939 742 (1971) to 1 318 220 (2000) in Okinawa. RESULTS A total of 5264 patients, 2981 males and 2265 females, have initiated maintenance hemodialysis during the study period. The incidence rate of ESRD increased from 8.9 to 370 pmp in males and from 0 to 227 pmp in females between 1971 and 2000. The growth was fast and consistent throughout the period in males, while in females, the growth has become slower since 1990. After age-standardized, a similar trend was observed, which increased from 41 to 224 pmp in males and from 36 to 154 pmp in females between 1975 and 2000. For males and females, the age-specific incidence rate in the 60–79 year and &amp;gt;80 year groups increased rapidly, and that in the 40–59 year group increased gradually, whereas in the 0–39 year group have been flat. The age-specific rate in the 60–79 year and &amp;gt;80 year groups for males continued to increase throughout the period, while that for females peaked between 1990 and 1995. In the cause-specific incidence rate, the following trends were observed in males and females. The incident rate caused by chronic glomerular nephropathy increased from the 1970s to the 1980s and then leveled off, while that by diabetic nephropathy increased from the 1980s and that by nephrosclerosis increased from the 1990s. The marked growth was seen in the incident rate caused by diabetic nephropathy for both males and females. The rate increased 31 times for males and 12 times for females in the 20 years from 1981 to 2000. The age- and cause-specific incidence rate has risen remarkably among male diabetic nephropathy in &amp;gt;60 years. CONCLUSION In Okinawa, the incidence rate of ESRD has increased significantly in males compared with females, and the gender difference has been widening. It was suggested that the increase in the number of males with diabetic nephropathy over the age of 60 contributed to this widening of the gender difference.

Gender differences in incidence and in-hospital outcomes of community-acquired, ventilator-associated and nonventilator hospital-acquired pneumonia in Spain.

We aim to compare the incidence and in-hospital outcomes of community-acquired pneumonia (CAP), ventilator-associated pneumonia (VAP) and nonventilator hospital-acquired pneumonia (NV-HAP) according to gender. This was a retrospective observational epidemiological study using the Spanish National Hospital Discharge Database for the years 2016 and 2017. Of 277785 hospital admissions, CAP was identified in 257455 (41.04% females), VAP was identified in 3261 (30.42% females) and NV-HAP was identified in 17069 (36.58% females). The incidence of all types of pneumonia was higher amongst males (CAP: incidence rate ratio [IRR] 1.05, 95% CI 1.03-1.06; VAP: IRR 1.36, 95% CI 1.26-1.46; and NV-HAP: IRR 1.16, 95% CI 1.14-1.18). The crude in-hospital mortality (IHM) rate for CAP was 11.44% in females and 11.80% in males (P=.005); for VAP IHM, the rate was approximately 35% in patients of both genders and for NV-HAP IHM, the rate was 23.97% for females and 26.40% for males (P<.001). After multivariable adjustment, in patients of both genders, older age and comorbidities were factors associated with IHM in the three types of pneumonia analysed. Female gender was a risk factor for IHM after VAP (OR 1.24; 95% CI 1.06-1.44), and no gender differences were found for CAP or NV-HAP. Our findings show a difference between females and males, with females presenting a lower incidence of all types of pneumonia. However, female gender was a risk factor for IHM after VAP.

Gender Differences in Incidence, Diagnosis, Treatments, and Outcomes in Clinically Localized Bladder and Renal Cancer

ObjectiveTo review differences in bladder and renal cell cancer (RCC) incidence, diagnosis, treatment, and outcomes between men and women, and to summarize the evidence that explains these differences. MethodsA review of the current literature was performed using PubMed and Google Scholar. ResultsThe incidence of bladder cancer and RCC is higher in men. Historically higher smoking rates among men explain some but not all of the difference in incidence. Hormonal and genetic factors also contribute. In bladder cancer, the androgen receptor and estrogen receptor beta have been associated with gender and tumor characteristics. In RCC the relationships are less well defined. In both bladder cancer and RCC, differences in gene mutation patterns among men and women, particularly among genes located on the X-chromosome, have also been identified. Differences in the work-up and treatment of men and women with bladder cancer and RCC also contribute to gender disparities. ConclusionResearch to better delineate how the hormonal axis and genetics contribute to disparities in bladder cancer and RCC incidence and outcomes will allow for more individualized medicine. Appreciation of barriers to diagnosis and treatment will identify opportunities to improve patient care.

Gender Differences in Incidence and Fatality of Severe Fever with Thrombocytopenia Syndrome in China: A Comparative Study Based on National Surveillance Data

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease, which has a substantial burden in eastern Asia and an increasingly global concern. Differences in infectious diseases between male and female individuals are an important public health problem. Methods: We used the database containing all reported SFTS cases in mainland China, and conducted systematic evaluation of gender differences in incidence and fatality in relation to age, temporal and spatial distribution, residence location and some clinical factors. Findings: A total of 15234 SFTS cases were reported during 2010-2018. Female individuals had significantly higher average annual incidence rate (AAIR) with a RR of 1·21 (95% CI 1·17-1·25; p˂0·0001), but significantly lower case fatality rate (CFR) with an OR of 0·74 (95% CI 0·63-0.85; p<0·0001). Both AAIR and CFR were age-dependent, and significant differences were observed in age groups of 40-69 and 50-69 years, respectively (all p<0·05). There was a rising incidence and declining CFR along with epidemic years. The AAIR and CFR varied greatly from province to province. However, higher AAIR and lower CFR in females were present among epidemic years and in affected provinces. After adjusting for potential confounders, the female-to-male difference in either AAIR or CFR remained significant. Interpretation: We elucidate an age-dependent gender dimorphism, in which the SFTS incidence is higher, but the fatality is lower for females. Further epidemiological and biological investigations are required to better understand the gender-specific differences for effective interventions. Funding Statement: This study was supported by Natural Science Foundation of China (81621005). Declaration of Interests: The authors declare that they have no conflicts of interest. Ethics Approval Statement: As this study constituted public health surveillance rather than research in human beings, ethical approval from institutional review boards was not required. All the information regarding individual persons had been anonymized in data collection.

P1726A gender perspective on incidence, management, short- and long term outcome of cardiogenic shock complicating ST-elevation myocardial infarction - A report from the SWEDEHEART register

Abstract Background Cardiogenic shock [CS] is a severe complication of ST-elevation myocardial infarction [STEMI]. An increased use of primary percutaneous coronary intervention [PPCI] has been associated with a decline in CS incidence, and a better prognosis. Female gender has been associated with a worse prognosis in STEMI, but whether there is a gender difference in incidence and outcome of CS complicating STEMI is not known. Purpose The objectives of this study were to compare the genders regarding incidence, management, and prognosis of CS complicating STEMI. Methods Patients with STEMI and CS were identified in SWEDEHEART 2005–2014. Cardiogenic shock was defined as any of; 1) systolic blood pressure [BP] &lt;90 mm Hg ≥30 min, 2) signs of tissue hypoperfusion, 3) cardiac index &lt;1,8 l/min/m2, 4) ionotropic drugs and/or need of intra-aortic balloon pump. Multiple logistic and cox regression analyses were done with reperfusion therapy, in-hospital and 1-year mortality as dependent variables. Results Among 56072 STEMI patients 3134 CS cases were identified. Women more often than men developed CS (6.3 vs 5.2%, p&lt;0.001). The age-adjusted incidence of CS did not change in women, whereas in men the incidence increased by 2.7% yearly. Women had a less chance of receiving reperfusion therapy, OR 0.77 (95% CI 0.65–0.92), but had neither higher in-hospital mortality (OR 1.01, 95% CI 0.85–1.19), nor higher 1-year mortality (OR 0.97, 95% CI 0.70–1.33). Upon age stratification the gender difference in reperfusion was only evident among the oldest (&gt;80 years). Conclusion Women had higher risk of CS than men when stricken by STEMI, but whereas CS incidence increased in men it was stable in women. Although women had less likelihood of receiving reperfusion therapy, adjusted in-hospital, and 1-year mortality was without any gender difference. The rate of reperfusion was especially low in elderly women, where there seems to be room for improvement.

Diverticular disease epidemiology: acute hospitalisations are growing fastest in young men.

Older age has long been linked to risk of diverticulitis, but the epidemiology is seldom described for a national population. The aim of this study was to investigate age- and gender differences in incidence, temporal trends, lifetime risk and prevalence related to acute diverticulitis hospitalisations in New Zealand. Records of all hospitalisations with diverticulitis the primary diagnosis were obtained from the Ministry of Health for the period 2000-2015. The first acute diverticulitis admission recorded for an individual was taken as an incident event; all others were classified as recurrent. Trends in age- and sex-specific and age-standardised incidence rates are described, and lifetime risk and prevalence estimated. Over the 16years from 2000 to 2015, 37,234 acute hospitalisations for diverticulitis were recorded in 28,329 people aged 30 + years (median = 66years). Rates of incident hospitalisations rose with age, from 5/10,000 person-years at age 50-54years to 19/10,000py by age 80-84years. Rates for women were lower than men before age 55years, but higher thereafter. Age-standardised rates rose 0.2/10,000py annually, but approximately doubled among men aged < 50years. Lifetime risk was estimated at over 5%, with the prevalence pool rising to over 1.5% of the population aged 30+ in 2030. Rapid increases in diverticulitis admissions among young men since 2000 correspond with increases reported elsewhere but remain unexplained; notably young women follow similar trends 5-10years later. Increasing incidence, combined with population ageing, adds urgency to explain diverticular formation, to understand factors that trigger or provoke their inflammation/infection, and to clarify treatment and (self-)management pathways.

Effect of Gender on Unplanned Readmissions After Percutaneous Coronary Intervention (from the Nationwide Readmissions Database)

Women who undergo percutaneous coronary intervention (PCI) are at higher risk of adverse outcomes compared with men, but it is unknown whether gender affects early unplanned rehospitalization. We analyzed 832,753 patients who underwent PCI from 2013 to 2014 in the Nationwide Readmissions Database. We compared gender differences in incidences, predictors, causes, and cost of unplanned 30-day readmissions and examined the effect of co-morbidity. A total of 832,753 men and women who survived the index PCI and were not admitted for a planned readmission were included in the analysis. Overall, 9.4% of patients had an unplanned readmission within 30 days. Thirty-day readmission rates were higher in women compared with men (11.5% vs 8.4%, p <0.001) even after multivariate adjustment (odds ratio 1.19, 95% confidence interval 1.16 to 1.22, p <0.001), although women had significantly lower costs associated with the readmission ($11,927 vs $12,758, p <0.001). The cause of readmission for women and men were similar and the majority of the readmissions were due to noncardiac causes (58% vs 55%), the most common of which were nonspecific chest pain, gastrointestinal disease, and infections. In contrast, for cardiac readmissions, women are more likely to be readmitted for heart failure (29.64% vs 22.34%), whereas men are more likely to be readmitted for coronary artery disease, including angina (33.47% vs 28.54%). In conclusion, gender disparities exist in rates of unplanned rehospitalization after PCI, where more than 1 in 10 women who undergo PCI are readmitted within 30 days. Gender differences were not observed for causes of noncardiac readmissions, whereas important differences were observed for cardiovascular causes.

Increase of Reproductive Life Span Delays Age of Onset of Parkinson's Disease.

One striking observation in Parkinson’s disease (PD) is the remarkable gender difference in incidence and prevalence of the disease. Data on gender differences with regard to disease onset, motor and non-motor symptoms, and dopaminergic medication are limited. Furthermore, whether estrogen status affects disease onset and progression of PD is controversially discussed. In this retrospective single center study, we extracted clinical data of 226 ambulatory PD patients and compared age of disease onset, disease stage, motor impairment, non-motor symptoms, and dopaminergic medication between genders. We applied a matched-pairs design to adjust for age and disease duration. To determine the effect of estrogen-related reproductive factors including number of children, age at menarche, and menopause on the age of onset, we applied a standardized questionnaire and performed a regression analysis. The male to female ratio in the present PD cohort was 1.9:1 (147 men vs. 79 women). Male patients showed increased motor impairment than female patients. The levodopa equivalent daily dose was increased by 18.9% in male patients compared to female patients. Matched-pairs analysis confirmed the increased dose of dopaminergic medication in male patients. No differences were observed in age of onset, type of medication, and non-motor symptoms between both groups. Female reproductive factors including number of children, age at menarche, and age at menopause were positively associated with a delay of disease onset up to 30 months. The disease-modifying role of estrogen-related outcome measures warrants further clinical and experimental studies targeting gender differences, specifically hormone-dependent pathways in PD.

Gender Differences in the Incidence and Determinants of Components of the Frailty Phenotype Among Older Adults: Findings From the SABE Study.

To analyze gender differences in incidence and determinants of the components of the frailty phenotype. A total of 1,413 older adults were selected in 2006. To estimate the incidence of each frailty component, only individuals who did not exhibit a given component at baseline (independently of the presence of other components) were included in the study. The variables of interest were socioeconomic, behavioral, clinical, anthropometric factors and physical performance. The incidence of each component in 2010 was the outcome. Unintentional weight loss and slowness were more incident in men up to 74 years of age. The other frailty components were more incident in women at all age groups, except weakness. Besides age, the determinants of incidence of the components of frailty were different between genders. Strategies for preventing or delaying the installation of frailty need to address gender differences, considering the greater complexity in the network determinants among women.