Demographic and Survivorship Disparities in Non–muscle-invasive Bladder Cancer in the United States.
- Author:
Munseok SEO
1
;
James R LANGABEER II
Author Information
- Publication Type:Original Article
- Keywords: Risk; Urinary bladder neoplasms; Aged; Survival analysis
- MeSH: Aged; Demography; Epidemiology; Health Policy; Hispanic Americans; Humans; Male; Marital Status; Registries; Single Person; Survival Analysis; Survival Rate*; United States*; Urinary Bladder Neoplasms*; Urinary Bladder*
- From:Journal of Preventive Medicine and Public Health 2018;51(5):242-247
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVES: To examine survivorship disparities in demographic factors and risk status for non–muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. METHODS: We used the US National Cancer Institute’s Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. RESULTS: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p < 0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. CONCLUSIONS: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.
