Women are at higher risk than men for recurrence and progression of nonmuscle-invasive bladder cancer (NMIBC) following treatment with intravesical bacillus Calmette-Guérin (BCG), according to study findings presented at the Society of Urologic Oncology 2020 virtual annual meeting.

In a retrospective study of 417 men and 112 women who received intravesical BCG for NMIBC, women were 1.7 times and 3.0 times more likely to have disease recurrence and progression, respectively, compared with men after adjusting for T-stage, grade, tumor size, and other variables, reported Jonathan Fadel, MD, of CHU de Quebec Center, Laval University, in Quebec City, Canada, and colleagues. Women had these higher risks despite their better tolerance of full intravesical BCG protocols, according to the investigators.

A significantly higher proportion of women than men completed at least 6 induction plus 9 maintenance BCG instillations (45% vs 31%).

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During a median follow-up time of 3.7 years, 206 men (49.4%) and 40 women (35.7%) had recurrences.

Study strengths included a large cohort of patients at a single center that provides care for an entire city and referral region in a universal healthcare system, Dr Fadel and his colleagues noted. Study limitations included the non-consecutive nature of the patients.


Fadel J, Harvey JS, Lanteigne G, et al. Sex differences in the effectiveness of intravesical BCG for non-muscle invasive bladder cancer. Presented at: Society of Urologic Oncology 2020 virtual annual meeting, December 3-5. Poster 32.