Disparities in Stage at Diagnosis in an Equal-access Integrated Delivery System: A Retrospective Cohort Study of 7244 Patients With Bladder Cancer

Danforth, Kim N.; Luong, Tiffany; Yi, David; Yamamoto, Ayae; Kawatkar, Aniket A.; Kim, Philip H.; Loo, Ronald K.; Sidell, Margo; Williams, Shanna

doi:10.1016/j.clgc.2019.09.002

Cited by 14 publications

(7 citation statements)

References 14 publications

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“…Another finding reported a sharp increase in cancer-specific mortality after 24-month follow-up despite differences in bladder cancer severity at the time of presentation and found worst survival rate among female and African American patients [19]. This disparity might be attributed to differences in disease stage at diagnosis, utilization of cancer therapy, biologic factors, social determinants of health, diet, physical activity, and socioeconomic factors as females and African American bladder cancer patients are known to present with more advanced stage of cancer and are more at risk of occupational exposure associated with bladder cancer than Whites and Asians [19,37,[41][42][43][44][45][46].…”

Section: Discussionmentioning

confidence: 99%

Exploring racial disparities in bladder urothelial cancer: insights into survival and genetic variations

Abubakar,

Bello,

Gusau

et al. 2024

Afr J Urol

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Background Bladder urothelial cancer is the most common malignancy of the urinary system and the 10th most common cancer worldwide with incidence appearing to show a geographical and exposure pattern. Advances in genomic technologies provide abundant data and insight into tumors at the single-cell resolution and are usually stored in repositories like The Cancer Genome Atlas (TCGA). However, data sources for the TCGA appear to be focused on European and American populations. The extent to which genomic and survival data can be applied to populations not included in the study remains somewhat uncertain. Methods We explored the genomic and survival characteristics of the TCGA pan-cancer atlas of bladder urothelial cancer. We decluttered these characteristics based on racial groups and compared between and among the races and the overall dataset. Results Significant variations were seen in age groups especially Asians (51–60) years and Blacks (61–70) years compared to Whites and the BLCA dataset with a statistically significant difference in mean diagnosis age (p = 0.0048) between Asians and the whole dataset. Overall survival characteristics were similar but genetic features were vastly different. Significant inter-racial alterations could be seen among genes involved in different pathways, oncogenes, tumor suppressors, cytoband amplification and/or deletion, mutation count, and aneuploidy scores. Conclusion The TCGA pan-cancer atlas for bladder urothelial cancer adequately represents White populations only. The genomic features do not apply to Blacks and Asians. We recommend better coverage for other populations to ensure adequate data for clinicians and researchers.

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Section: Discussionmentioning

confidence: 99%

Exploring racial disparities in bladder urothelial cancer: insights into survival and genetic variations

Abubakar,

Bello,

Gusau

et al. 2024

Afr J Urol

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“…Recent efforts have identified sex and racial disparities in BC (28,29). It is also worth mentioning that BC is one of the top nonreproductive cancers exhibiting stark male and female differences: men are at a 3-5 times greater risk of developing BC, while females are more likely to be diagnosed with advanced-stage disease (30).…”

Section: Discussionmentioning

confidence: 99%

Long-term cardiovascular mortality risk in patients with bladder cancer: a real-world retrospective study of 129,765 cases based on the SEER database

Liao,

Zhou

2023

Front. Cardiovasc. Med.

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IntroductionAmong 28 cancer types, bladder cancer (BC) patients have the highest risk of dying from cardiovascular disease (CVD). We aimed to identify the independent risk factors and develop a novel nomogram for predicting long-term cardiovascular mortality in patients with BC.MethodsWe extracted data from the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with bladder cancer (BC) between 2000 and 2017. The cumulative incidence function (CIF) was computed for both CVD-related death and other causes of death. Then we performed univariate and multivariate analyses to explore the independent risk factors and further develop a novel nomogram to predict cardiovascular mortality at 5- and 10-year for patients with BC by using the Fine-Gray competing risk model. The efficacy of the developed nomogram was assessed by the concordance index (C-index), receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).ResultsA total of 12,9765 patients were randomly divided into training (n = 90,835, 70%), and validation (n = 38,930, 30%) cohorts. During the follow-up period, 31,862 (46.4%) patients died from BC, and 36793 (53.6%) patients died from non-BC, of which CVD-related death accounted for 17,165 (46.7%), being the major cause of non-cancer deaths. The multivariate analysis showed that age, sex, race, marital status, histologic type, tumor grade, summary stage, and chemotherapy were independent risk factors of CVD-related death in BC patients. The nomogram based on the above eight factors showed good discrimination power, excellent consistency, and clinical practicability: (1) the areas under the curve of the ROC for 5- and 10-year CVD-related death of 0.725 and 0.732 in the training cohort and 0.726 and 0.734 in the validation cohort; (2) the calibration curves showed that the prediction probabilities were basically consistent with the observed probabilities; (3) the DCA curves revealed that the nomogram had high positive net benefits.DiscussionTo our knowledge, this was the first study to identify the independent risk factors and develop a novel nomogram for predicting long-term cardiovascular mortality in patients with BC based on the competing risk model. Our results could help clinicians comprehensively and effectively manage the co-patient of BC and CVD, thereby reducing the risk of cardiovascular mortality in BC survivors.

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“…The tumor stage is determined based on the TNM classification system, where T indicates the size of the primary tumor and invasion into the bladder wall, N is the extent of regional lymph node involvement, and M is the presence of distant metastasis [ 45 ]. Compared with age-matched male-gender patients, female-gender patients present with higher-stage bladder cancer (T2 and higher) on primary diagnosis and are more likely to have N+ and M+ staged disease [ 25 , 26 , 46 ]. Female-gender patients also have higher-grade disease compared with male-gender patients on initial diagnosis [ 28 ].…”

Section: Clinical Aspects Of Sex and Gender Differences In Bladder Ca...mentioning

confidence: 99%

“…Also, AA MIBC patients are less likely to receive the standard treatment regimen, i.e., neo-adjuvant chemotherapy plus cystectomy [21]. Differences in disease presentation, diagnosis, and treatment all contribute to an increased risk of mortality and shorter survival for AA bladder cancer patients [24][25][26]. There are many race-specific differences in tumor biology that likely contribute to racial disparities in bladder cancer.…”

Section: Race and Ethnicitymentioning

confidence: 99%

Biological differences underlying sex and gender disparities in bladder cancer: current synopsis and future directions

Doshi,

Athans,

Woloszynska

2023

Oncogenesis

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Sex and gender disparities in bladder cancer have long been a subject of interest to the cancer research community, wherein men have a 4 times higher incidence rate than women, and female patients often present with higher-grade disease and experience worse outcomes. Despite the known differences in disease incidence and clinical outcomes between male and female bladder cancer patients, clinical management remains the same. In this review, we critically analyze studies that report on the biological differences between men and women and evaluate how these differences contribute to sex and gender disparities in bladder cancer. Distinct characteristics of the male and female immune systems, differences in circulating hormone levels and hormone receptor expression, and different genetic and epigenetic alterations are major biological factors that all likely contribute to disparate incidence rates and outcomes for male and female bladder cancer patients. Future preclinical and clinical studies in this area should employ experimental approaches that account for and consider sex and gender disparities in bladder cancer, thereby facilitating the development of precision medicine for the effective treatment of bladder cancer in all patients.

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Disparities in Stage at Diagnosis in an Equal-access Integrated Delivery System: A Retrospective Cohort Study of 7244 Patients With Bladder Cancer

Cited by 14 publications

References 14 publications

Exploring racial disparities in bladder urothelial cancer: insights into survival and genetic variations

Exploring racial disparities in bladder urothelial cancer: insights into survival and genetic variations

Long-term cardiovascular mortality risk in patients with bladder cancer: a real-world retrospective study of 129,765 cases based on the SEER database

Biological differences underlying sex and gender disparities in bladder cancer: current synopsis and future directions

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