Sex and gender disparities in bladder cancer have long been a subject of interest to the cancer research community, wherein men have a 4 times higher incidence rate than women, and female patients often present with higher-grade disease and experience worse outcomes. Despite the known differences in disease incidence and clinical outcomes between male and female bladder cancer patients, clinical management remains the same. In this review, we critically analyze studies that report on the biological differences between men and women and evaluate how these differences contribute to sex and gender disparities in bladder cancer. Distinct characteristics of the male and female immune systems, differences in circulating hormone levels and hormone receptor expression, and different genetic and epigenetic alterations are major biological factors that all likely contribute to disparate incidence rates and outcomes for male and female bladder cancer patients. Future preclinical and clinical studies in this area should employ experimental approaches that account for and consider sex and gender disparities in bladder cancer, thereby facilitating the development of precision medicine for the effective treatment of bladder cancer in all patients.

膀胱癌的性别和性别差异长期以来一直是癌症研究界感兴趣的主题，其中男性的发病率是女性的 4 倍，而女性患者往往病情级别更高，预后更差。尽管已知男性和女性膀胱癌患者的发病率和临床结果存在差异，但临床治疗仍然相同。在这篇综述中，我们批判性地分析了报告男性和女性之间生物学差异的研究，并评估这些差异如何影响膀胱癌的性别和性别差异。男性和女性免疫系统的独特特征、循环激素水平和激素受体表达的差异以及不同的遗传和表观遗传改变是主要的生物学因素，这些因素都可能导致男性和女性膀胱癌患者不同的发病率和结果。该领域未来的临床前和临床研究应采用实验方法来解释和考虑膀胱癌的性别和性别差异，从而促进精准医学的发展，以有效治疗所有患者的膀胱癌。