Fabian, Ido Didi; Khetan, Vikas; Stacey, Andrew W; Allen Foster; Ademola-Popoola, Dupe S; Berry, Jesse L; Cassoux, Nathalie; Chantada, Guillermo L; Hessissen, Laila; Kaliki, Swathi; +17 more... Kivelä, Tero T; Luna-Fineman, Sandra; Munier, Francis L; Reddy, M Ashwin; Rojanaporn, Duangnate; Blum, Sharon; Sherief, Sadik T; Staffieri, Sandra E; Theophile, Tuyisabe; Waddell, Keith; Ji, Xunda; Astbury, Nicholas J; Bascaran, Covadonga; Burton, Matthew; Zondervan, Marcia; Bowman, Richard; Global Retinoblastoma Study Group; Global Retinoblastoma Study Group; (2021) Sex, gender, and retinoblastoma: analysis of 4351 patients from 153 countries. Eye (London, England), 36 (8). pp. 1571-1577. ISSN 0950-222X DOI: https://doi.org/10.1038/s41433-021-01675-y
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Abstract
OBJECTIVE: To investigate in a large global sample of patients with retinoblastoma whether sex predilection exists for this childhood eye cancer. METHODS: A cross-sectional analysis including 4351 treatment-naive retinoblastoma patients from 153 countries who presented to 278 treatment centers across the world in 2017. The sex ratio (male/female) in the sample was compared to the sex ratio at birth by means of a two-sided proportions test at global level, country economic grouping, continent, and for selected countries. RESULTS: For the entire sample, the mean retinoblastoma sex ratio, 1.20, was higher than the weighted global sex ratio at birth, 1.07 (p < 0.001). Analysis at economic grouping, continent, and country-level demonstrated differences in the sex ratio in the sample compared to the ratio at birth in lower-middle-income countries (n = 1940), 1.23 vs. 1.07 (p = 0.019); Asia (n = 2276), 1.28 vs. 1.06 (p < 0.001); and India (n = 558), 1.52 vs. 1.11 (p = 0.008). Sensitivity analysis, excluding data from India, showed that differences remained significant for the remaining sample (χ2 = 6.925, corrected p = 0.025) and for Asia (χ2 = 5.084, corrected p = 0.036). Excluding data from Asia, differences for the remaining sample were nonsignificant (χ2 = 2.205, p = 0.14). CONCLUSIONS: No proof of sex predilection in retinoblastoma was found in the present study, which is estimated to include over half of new retinoblastoma patients worldwide in 2017. A high male to female ratio in Asian countries, India in specific, which may have had an impact on global-level analysis, is likely due to gender discrimination in access to care in these countries, rather than a biological difference between sexes.
Item Type | Article |
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Faculty and Department | Faculty of Infectious and Tropical Diseases > Dept of Clinical Research |
Research Centre | International Centre for Eye Health |
PubMed ID | 34272514 |
Elements ID | 164367 |