Bladder Cancer Coverage from Every Angle

Are There Racial Disparities in BCG Treatment of Non–Muscle Invasive Bladder Cancer?

By: Vanessa A. Carter, BS
Posted: Monday, March 1, 2021

Stephen B. Williams, MD, of The University of Texas Medical Branch, Galveston, and colleagues studied the outcome disparity of equal access Bacillus Calmette-Guérin (BCG) treatment based on race in patients with non–muscle invasive bladder cancer. At the 2020 Annual Meeting of the Society of Urologic Oncology (SUO; Abstract 33), the researchers revealed that despite Black patients having a lower average socioeconomic status, there seemed to be no difference in treatment administration, recurrence, disease progression, or death from their disease compared with members of other races.

From a total of 63,139 individuals, the investigators identified 412 patients with high-risk non–muscle invasive bladder cancer who received at least one dose of BCG at a Veterans Affairs Health System center in the United States. Adequate induction BCG was defined as receiving at least five of six installations, and adequate BCG therapy was defined as receiving at least seven installations.

Of the total, 12% of patients were Black, and 84% were White. Smoking status, age, sex, and Charlson Comorbidity Index by race did not differ between these two groups. On average, Black patients were reported to have a lower socioeconomic status, with 50% being under the poverty line, whereas 21% of White patients were under the poverty line.

Adequate induction BCG was administered in 95% of patients, and 37% of patients received adequate BCG therapy. When accounting for race, the researchers found no notable difference in adequate BCG therapy or adequate induction BCG. There also seemed to be no significant difference found for disease progression (hazard ratio = 0.87), recurrence (hazard ratio = 1.43), disease-specific survival (hazard ratio = 1.21), or overall survival (hazard ratio = 1.38) between the Black and White patients in this study.

Disclosure: The meeting provided no disclosure information on the authors.

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