膀胱癌的性别差异一直是癌症研究界感兴趣的课题，其中男性的发病率比女性高4倍，女性患者通常呈现更高级别的疾病，并且有较差的预后。尽管已知男性和女性膀胱癌患者在疾病发病率和临床预后方面存在差异，但临床管理仍保持不变。在本综述中，我们对报告男性和女性之间生物差异的研究进行了批判性分析，并评估了这些差异如何影响膀胱癌的性别差异。男性和女性免疫系统的不同特征、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都是导致男女膀胱癌患者发病率和预后不同的主要生物因素。未来在这一领域的临床前和临床研究应当采用考虑和考虑膀胱癌的性别差异的实验方法，从而促进精确医学的发展，有效治疗所有患者的膀胱癌。© 2023. Springer Nature America, Inc.

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.© 2023. Springer Nature America, Inc.