J Prev Med Public Health.
2018 Sep;51(5):242-247. 10.3961/jpmph.18.092.
Demographic and Survivorship Disparities in Non–muscle-invasive Bladder Cancer in the United States
- Affiliations
-
- 1School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA. munseok.seo@uth.tmc.edu
- 2School of Public Health, University of Texas Health Science Center, Houston, TX, USA.
- KMID: 2424397
- DOI: http://doi.org/10.3961/jpmph.18.092
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.
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