Sex specific associations in genome wide association analysis of renal cell carcinoma

Renal cell carcinoma (RCC) has an undisputed genetic component and a stable 2:1 male to female sex ratio in its incidence across populations, suggesting possible sexual dimorphism in its genetic susceptibility. We conducted the first sex-specific genome-wide association analysis of RCC for men (3227 cases, 4916 controls) and women (1992 cases, 3095 controls) of European ancestry from two RCC genome-wide scans and replicated the top findings using an additional series of men (2261 cases, 5852 controls) and women (1399 cases, 1575 controls) from two independent cohorts of European origin. Our study confirmed sex-specific associations for two known RCC risk loci at 14q24.2 (DPF3) and 2p21(EPAS1). We also identified two additional suggestive male-specific loci at 6q24.3 (SAMD5, male odds ratio (OR_male) = 0.83 [95% CI = 0.78-0.89], P_male = 1.71 × 10^-8 compared with female odds ratio (OR_female) = 0.98 [95% CI = 0.90-1.07], P_female = 0.68) and 12q23.3 (intergenic, OR_male = 0.75 [95% CI = 0.68-0.83], P_male = 1.59 × 10^-8 compared with OR_female = 0.93 [95% CI = 0.82-1.06], P_female = 0.21) that attained genome-wide significance in the joint meta-analysis. Herein, we provide evidence of sex-specific associations in RCC genetic susceptibility and advocate the necessity of larger genetic and genomic studies to unravel the endogenous causes of sex bias in sexually dimorphic traits and diseases like RCC.