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We investigated whether sex differences in cancer incidence differed across race\/ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Within the Multiethnic Cohort Study, we examined the association between sex and cancer incidence at 13 shared anatomic sites using Cox proportional hazards regression to estimate male-to-female hazard ratios (MF HRs) adjusting for cancer specific risk factors by race\/ethnic group: African American, Japanese American, Native Hawaiian, Latino, and White. Statistical differences in the MF HRs by race\/ethnicity for each site were assessed with an interaction term. The percentage of sex difference in cancer incidence that was statistically explained by the risk factors within race\/ethnicity were quantified using a Peters-Belson approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 178,036 participants, 46% were male and 54% were female. Adjusting for multiple risk factors did not eliminate the MF differences for any of the cancers examined. We found significant differences in MF HRs across race\/ethnicity for cancers of the esophagus (Native Hawaiian MF HR 17.67, 95% CI 2.21\u2013141.20; African American 1.28 0.69\u20132.36;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.018), liver (Japanese American 1.28, 0.96\u20131.70; White 2.79, 1.81\u20134.30,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005) and thyroid (Latino 0.21, 0.13\u20130.35; White 0.83, 0.50\u20131.37,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.005). Cancer risk factors explained 82% of the overall sex difference observed for lung cancer but 0% of the difference for gallbladder cancer.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Most non-sex-specific cancers have male predominance across race\/ethnicity, which are not fully explained by cancer risk factors, suggesting there may be intrinsic sex differences driving these differences in cancer incidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13293-026-00902-z","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:17:20Z","timestamp":1777382240000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex differences in cancer incidence persist across race and ethnicity"],"prefix":"10.1186","volume":"17","author":[{"given":"Julia J.","family":"Francis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hormuzd A.","family":"Katki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry I.","family":"Graubard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Haiman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lo\u00efc Le","family":"Marchand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica Wendy","family":"Setiawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne R","family":"Wilkens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Chaturvedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6986-8842","authenticated-orcid":false,"given":"Sarah S.","family":"Jackson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"902_CR1","unstructured":"Cancer Statistics. https:\/\/www.cancer.gov\/about-cancer\/understanding\/statistics (May 9, 2024; date last accessed)."},{"issue":"9","key":"902_CR2","doi-asserted-by":"publisher","first-page":"e35833","DOI":"10.1002\/cncr.35833","volume":"131","author":"RL Sherman","year":"2025","unstructured":"Sherman RL, Firth AU, Henley SJ, et al. 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