Ethnic Differences in Bladder Cancer Survival

Abstract

Objectives Racial disparities in bladder cancer outcomes have been documented with poorer survival observed among blacks. Bladder cancer outcomes in other ethnic minority groups are less well described. We examined trends in bladder cancer survival among whites, blacks, Hispanics, and Asian/Pacific Islanders in the US over a 30-year period. Methods From the Surveillance, Epidemiology and End Results cancer registry data, we identified patients diagnosed with transitional cell carcinoma of the bladder between 1975 and 2005. This cohort included 163,973 white, 7,731 black, 7,364 Hispanic and 5,934 Asian/Pacific Islander patients. We assessed the relationship between ethnicity and patient characteristics. Disease-specific 5-year survival was estimated for each ethnic group and for subgroups of stage and grade. Results Blacks presented with higher stage disease than whites, Hispanics and Asian/Pacific Islanders, although a trend toward earlier stage presentation was observed in all groups over time. Five-year disease-specific survival was consistently worse for blacks than for other ethnic groups, even when stratified by stage and grade. Five-year disease-specific survival was 82.8% in whites compared with 70.2% in blacks, 80.7% in Hispanics and 81.9% in Asian/Pacific Islanders. There was a persistent disease-specific survival disadvantage in black patients over time which was not seen in the other ethnic groups. Conclusions Ethnic disparities in bladder cancer survival persist between whites and blacks, while survival in other ethnic minority groups appears similar to that of whites. Further study of access to care, quality of care and treatment decision making among black patients is needed to better understand these disparities.

Essentials of bladder cancer worldwide: incidence, mortality rate and risk factors

“…The incidence of BC in white men is twice that of black men. However, the prognosis of BC in black patients is worse than white patients (Yee et al, 2011). The highest standardized mortality rates were 6.6 in Turkey (Antoni et al, 2017), 6.5 in Egypt (Chavan et al, 2014), 6.3 in Iraq (Mahdavifar et al, 2016), 6.3 in Lebanon (Mahdavifar et al, 2016), and 5.2 in Mali (Chavan et al, 2014), per 100,000 people.…”

“…It seems that one main reason for the lower incidence of BC in women is the lower prevalence of smoking and lower occupational risk in women (Burger The risk of BC is two times higher in Whites than in African Americans. In the United States, the age-standardized rates for African Americans are 13 per 100,000 and for Whites are 22 per 100,000 (Yee et al, 2011). BC rates are lower in Asian Americans, Indian Americans, and Spaniards than other races.…”

Cause–effect? Understanding the risk factors associated with bladder cancer

“…Despite lower incidence rates, being of a black race has also been shown to be associated with worse survival. More recently, marital status and socioeconomic status have been shown to be associated with survival in bladder cancer patients [19,20].…”

Effect of African-American Race on Tumor Recurrence After Radical Cystectomy for Urothelial Carcinoma of the Bladder

“…27 Previously reported outcomes on health disparities using the Surveillance, Epidemiology, and End Results data and large retrospectively assembled data sets demonstrated that African Americans presented with higher stage disease than did whites, Hispanics, and Asian/Pacific Islanders. 28 Also, the 5-year disease-specific survival was consistently worse for African Americans than for other ethnic groups, even when stratified by stage and grade. 28 Another study demonstrated that the survival differences in patients with UCB when stratified by race were limited to patients with muscle-invasive disease.…”