The Impact of Sex & Gender on Equity and Access to Cancer Care for Kidney Transplant Recipients

Cancer mortality in kidney transplant recipients differs by age and sex. This indicates possible systemic biases in the delivery of cancer care. There is a need to evaluate current clinical practice to identify points of sex and gender inequity in and healthcare delivery for cancer management in kidney transplant recipients.

Cancer disproportionally impacts kidney transplant recipients, but it affects men and women differently. Male kidney transplant recipients have higher absolute cancer incidence and mortality compared to females; however, female kidney transplant recipients experience greater excess cancer death^(1,2). Sex and gender differences have also been described in access to healthcare and consequently there has been an increase of gender-based health plans, particularly in cardiovascular disease^(3,4).

Investigation of how sex impact access to cancer care may identify systemic biases in cancer care delivery to kidney transplant recipients.

Using existing health data and survey of kidney transplant recipients, our work asks, how do sex and gender impact access and equity in cancer care for kidney transplant recipients?

What does the data say?
We will use evidence integration and population data to investigate the impact of sex on access to cancer screening, efficacy of cancer treatment and, relative survival in kidney transplant recipients with cancer.

What do our patients say?
We will explore gender-based experiences of cancer care in kidney transplant recipients using focus-group interviews and online preferences surveys to identify barriers in access and elicit patient preferences for treatment.

What does it mean for our patients?
Our work will provide a better understanding of the varied needs of males, females and people of nonbinary gender and, how current cancer prevention and treatment strategies differ by sex & gender. Our findings will inform strategies to deliver more equitable cancer care for kidney transplant recipients to balance its benefits and harms.

Literature

1. Rosales et al. 2020, IntJCancer (doi:10.1002/ijc.32585)
2. Rosales et al. 2022, AJKD (doi:10.1053/j.ajkd.2022.03.010)
3. De La Mata et al. 2021, BMJ (doi:10.1136/BMJ-2021-068247)
4. Wyld et al. 2020, Transplantation (DOI: 10.1097/TP.0000000000003224)