在大多数共享的解剖部位，男性患癌症的风险比女性高 2-3 倍，这可能反映了女性对癌症的免疫监视增强。我们检查了免疫功能低下的成年人中是否仍然存在这些性别差异。利用移植癌症匹配 (TCM) 研究，我们估计了 1995 年至 2017 年间诊断的 15 个癌症部位的 TCM 中男性与女性发病率比率 (M: F IRRTransplant)，使用泊松回归。一般人群中的 M: F IRR (M: F IRRGP) 是使用来自监测、流行病学和最终结果计划的预期癌症计数计算的，并根据年龄、种族/民族和诊断年份对移植人群进行了标准化。 M：使用卡方检验比较 F IRR。在 343,802 例实体器官移植中，211,206 例（61.4%）为男性，132,596 例（38.6%）为女性。移植受者中男性癌症发病率较高，但唇癌的性别差异有所减弱（M：F IRRTransplant：1.81 vs M：F IRRGP：3.96；P < 0.0001）、胃癌（1.51 vs 2.09；P = 0.002）、结直肠（0.98 vs 1.43；P < 0.0001）、肝脏（2.39 vs 3.44；P = 0.002）、肾（1.67 vs 2.24；P < 0.0001）、膀胱（2.02 vs 4.19；P < 0。 0001), 卡波西肉瘤（1.79 vs 3.26；P = 0.0009）和非霍奇金淋巴瘤（1.34 vs 1.64；P < 0.0001）。对于其他癌症部位，M:F IRRTransplant 与 M:F IRRGP 没有统计学差异。尽管男性实体器官移植受者的癌症发病率高于女性，但研究的许多癌症的 M:F 比率相对于一般人群的衰减可能表明免疫监视的重要性，由于移植后的免疫抑制，女性会失去一些优势。牛津大学出版社 2023 年出版。

Males have 2-3-fold greater risk of cancer than females at most shared anatomic sites, possibly reflecting enhanced immune surveillance against cancer in females. We examined whether these sex differences remained among immunocompromised adults.Using the Transplant Cancer Match (TCM) Study, we estimated the male-to-female incidence rate ratio in TCM (M: F IRRTransplant) for 15 cancer sites diagnosed between 1995-2017 using Poisson regression. M: F IRRs in the general population (M: F IRRGP) were calculated using expected cancer counts from the Surveillance, Epidemiology, and End Results Program, standardized to the transplant population on age, race/ethnicity, and diagnosis year. M: F IRRs were compared using a chi-square test.Among 343,802 solid organ transplants, 211,206 (61.4%) were among men and 132,596 (38.6%) among women. An excess cancer incidence in males was seen in transplant recipients, but the sex difference was attenuated for cancers of the lip (M: F IRRTransplant: 1.81 vs M: F IRRGP: 3.96; P < 0.0001), stomach (1.51 vs 2.09; P = 0.002), colorectum (0.98 vs 1.43; P < 0.0001), liver (2.39 vs 3.44; P = 0.002), kidney (1.67 vs 2.24; P < 0.0001), bladder (2.02 vs 4.19; P < 0.0001), Kaposi sarcoma (1.79 vs 3.26; P = 0.0009), and non-Hodgkin lymphoma (1.34 vs 1.64; P < 0.0001). The M: F IRRTransplant was not statistically different from the M: F IRRGP for other cancer sites.Although male solid organ transplant recipients have higher cancer incidence than females, the attenuation in the M: F ratio for many cancers studied relative to the general population might suggest the importance of immunosurveillance, with some loss of advantage in females due to immunosuppression following transplantation.Published by Oxford University Press 2023.