Gender, Sex and Other Factors in the Development of Neuroendocrine Neoplasms.

PURPOSE OF REVIEW: To examine how biological sex and gender influence the tumorigenesis of neuroendocrine neoplasms (NEN), integrating epidemiological evidence with hormonal, molecular, lifestyle and environmental factors. RECENT FINDINGS: Recent population-based studies demonstrate sex differences in NEN incidence, pathological characteristics and survival across multiple anatomical sites. Emerging evidence suggests that sex-hormone signalling, epigenetic regulation and the tumour microenvironment may contribute to these differences. Lifestyle and metabolic factors, including smoking and obesity, may further modify NEN susceptibility and interact with sex- and gender-related factors. Biological sex appears to be an important modifier of NEN development rather than simply a demographic characteristic. However, mechanistic evidence remains limited and the contribution of gender is poorly characterised. Prospective, sex-stratified studies integrating hormonal, molecular and environmental data are required to clarify these interactions and their potential clinical relevance.