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Epidemiologically, PBC is more commonly found in women. It's like the general population that has PBC is 90% overall women within the literature.
Men are fewer, and they're diagnosed later, and they generally have more advanced disease presentation with high risks of adverse outcomes, such as hepatocellular carcinoma and liver transplantation once cirrhosis is present.
Potential causes are unclear, however there is lower index of suspicion in men, and so there's later testing and just later diagnosis. There seems to be some biological immune hormonal differences, and there's historical underrepresentation of men in trials and registries, leading to less tailored risk-assessment tools towards men.
Similar to liver disease as a whole, there are some racial and ethnic disparities. Black and Hispanic patients have been reported to present with more advanced disease and experienced gap and access of care, especially subspecialty care and second line drugs, so they usually start on first light treatment. If that doesn't work, it takes longer time to transition them to second line drugs.
