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Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer.
In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Sex differences have been observed in multiple facets of cancer epidemiology, treatment and biology, and in most cancers outside the sex organs. Efforts to link these clinical differences to specific molecular features have focused on somatic mutations within the coding regions of the genome. We both confirm the results of exome studies, and also uncover previously undescribed sex differences.
These include sex-biases in coding and non-coding cancer drivers, mutation prevalence and strikingly, in mutational signatures related to underlying mutational processes. These results underline the pervasiveness of molecular sex differences and strengthen the call for increased consideration of sex in molecular cancer research. Sex disparities in cancer epidemiology include an increased overall cancer risk in males corresponding with higher incidence in most tumour types, even after adjusting for known risk factors 1 , 2.
Cancer mortality is also higher in males, due in part to better survival for female patients in many cancer types, including those of the colon and head and neck 3. Interestingly, female colorectal cancer patients respond better to surgery 4 and adjuvant chemotherapy, though this is partially due to biases in tumour location and microsatellite instability 5. Similarly, premenopausal female nasopharyngeal cancer patients have improved survival regardless of tumour stage, radiation or chemotherapy regimen 6.