Sex differences in cancer incidence: prospective analyses in the UK Biobank

Sep 23, 2026

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Sex differences in cancer incidence were evaluated between women and men and assessed for persistence after accounting for established risk factors. Prospective analyses within the UK Biobank examined associations between sex and risk of 15 cancers (plus 13 subtypes) using minimal and multivariable-adjusted Cox proportional hazards models. Multivariable models were stratified by age, deprivation index, and region, and adjusted for ethnicity, qualifications, height, BMI, smoking, alcohol, and site-specific risk factors.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Methods

Cohort design and baseline assessment

Results

Conclusion

[www.nature.com/bjc](www.nature.com/bjc British)[ British](www.nature.com/bjc British) Journal of Cancer ARTICLE OPEN Epidemiology Sex differences in cancer incidence: prospective analyses in the UK Biobank Maira Khan 1 ✉, Keren Papier1, Kirstin L. Pirie1, Tim J. Key 1, Joshua Atkins 1 and Ruth C. Travis1 © The Author(s) 2025 | | BACKGROUND: We examined differences in cancer incidence between women and men and the extent to which these persisted after accounting for established risk factors.
METHODS: Prospective analyses in the UK Biobank to examine associations between sex and risk of 15 cancers (and 13 subtypes) using minimal and multivariable-adjusted Cox proportional hazards regression models. Multivariable models were stratiﬁed for age, deprivation index, and region, and adjusted for ethnicity, qualiﬁcations, height, BMI, smoking status, alcohol, and site-speciﬁc risk factors.
RESULTS: During 10.5 (SD 2.2) years of follow-up, 32,315 incident cancers across 15 anatomical sites (58.1% in women) were identiﬁed in 470,771 individuals (53 .8% women) . Some differences in cancer risk between the sexes attenuated to the null in the multivariable-adjusted models, but men remained at greater risk than women for cancers at eight sites: oesophageal adenocarcinoma (hazard ratio 5.45; 95% conﬁdence interval, 4.18–7.12), gastric cardia (3.65; 2.48–5.38), bladder (3.47; 2.85–4.24), oral cavity (2.06; 1.69-2.51), liver (1.91; 1.48–2.47), kidney (1.77; 1.51–2.09), rectum (1.70; 1.47–1.96), and leukaemia (1.43; 1.21–1.69) . Men had lower risks for cancers of the breast, thyroid (0.36; 0.26–0.49), anus (0.41; 0.26–0.64), and lung adenocarcinoma (0.72;
0.62–0 84) | | | --- | --- | --- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | . .
CONCLUSION: Further research on these sex differences in risk may provide insights into cancer aetiology. | | | | | British Journal of Cancer (2025) 133:216–226; [https://doi.org/10.1038/s41416-025-03028-y](https://doi.org/10.1038/s41416-025-03028-y) | | | | | | INTRODUCTION Most cancers common to both sexes exhibit some level of sex difference, with generally higher incidence and mortality of cancers at non-reproductive sites in men than women [1–4] . In men, the risk is typically 1.5 to 3 times greater, except for cancers of the anus, gallbladder, and thyroid, where the incidence is higher in women [4–6] . Cancers of the bladder, oral cavity, oesophagus, and liver have nearly threefold higher incidence in men [4–6] . Between 2016 and 2018, age-standardised incidence rates for all cancers among adults aged 35–69 in the UK (excluding the two sites with the largest incidence, breast and prostate) were 363.8 per 100,000 for women and 422.3 per 100,000 for men [7] . Over the last 25 years, these cancer incidence rates have initially declined and then stabilised in men, while a modest annual increase has been observed in women [7] . The cancer sites with rising incidence rates in both sexes include cancers of the oral cavity, liver, kidney and melanoma, along with lung cancer in women [7], all sites which exhibit well-documented sex differences [4–6] . The differences in cancer incidence between sexes have been mostly attributed to differences in exposure to established risk factors, which are largely anthropometric (height and obesity), lifestyle related (smoking, alcohol consumption, diet, and physical activity), molecular (chronic inﬂammatory and endocrinological risk factors) and genetic (EXITS genes, mosaic Y-loss) [3, 6, 8]. Statistics on sex differences in cancer incidence are usually reported on a national registry level, and they do not account for the hypothesised individual-level cancer risk factors [4, 5, 8, 9]. There have also been limited large-scale cross-cancersite prospective cohort analyses of sex differences in cancer risk [6]. Exploring the underlying sex differenc

FAQs

What is the study’s main objective regarding sex differences in cancer incidence?

To examine differences in cancer incidence between women and men and determine whether those differences persist after accounting for established risk factors.

How were associations between sex and cancer risk analyzed?

Using prospective analyses in the UK Biobank with Cox proportional hazards regression models, including minimal and multivariable-adjusted approaches.

Which factors were included in the multivariable-adjusted models?

Models were stratified by age, deprivation index, and region, and adjusted for ethnicity, qualifications, height, BMI, smoking status, alcohol, and site-specific risk factors.

Sep 23, 2026

Uploaded by McQueen