HealthDay News — Among patients with stage IV bladder cancer, women are less likely than men to receive systemic chemotherapy, and they have lower overall survival (OS), according to a study published online in Cancer.

Tracy L. Rose, MD, MPH, from the University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill, and colleagues compared sex differences in demographics, systemic chemotherapy administration, and OS for all patients diagnosed with stage IV bladder cancer from 1998 through 2010, identified using the National Cancer Data Base.

The researchers identified 23,981 patients (35% female). There was no difference in the Charlson-Deyo comorbidity score for men and women. Compared with men, women were less likely to receive systemic chemotherapy (45% versus 52%; adjusted relative risk, 0.91). Compared with men, women had a lower median OS (8 versus 9.8 months; P < 0.001). On multivariate analysis, women had lower OS, even after adjustment for administration of systemic chemotherapy (hazard ratio for death, 1.11).

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“Women are less likely than men to receive systemic chemotherapy for advanced bladder cancer and this difference may partially account for the poorer OS observed in women,” the authors write. “However, OS remains lower in women independent of chemotherapy use, and may be related to unmeasured comorbidities, functional status, or tumor biology.”

One author disclosed financial ties to the pharmaceutical industry.

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  1. Rose TL, Deal AM, Nielsen ME, et al. Sex disparities in use of chemotherapy and survival in patients with advanced bladder cancer. Cancer. 2016; doi: 10.1002/cncr.30029
  2. Harshman LC. Mind the gap: What is driving the survival disparity between the sexes in bladder cancer? Cancer. 2016; doi: 10.1002/cncr.30027