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Are There Racial Disparities in Mortality in Muscle-Invasive Bladder Cancer?

By: Julia Fiederlein
Posted: Friday, January 15, 2021

A recent analysis, which was presented during the virtual edition of the 2020 Society of Urologic Oncology (SUO) Annual Meeting (Abstract 18), investigated the geographic distribution of muscle-invasive bladder cancer mortality according to race in the United States. Stephen B. Williams, MD, MS, of The University of Texas Medical Branch, Galveston, and colleagues explained that a further examination of the social determinants of race is needed to expand on their findings.

“African Americans have [an] up to two times increased risk of bladder cancer death than Caucasians,” the investigators commented. “We observed geographic variation in death from bladder cancer that impacted one registry, which had one of the largest populations of African Americans.”

The investigators analyzed Surveillance, Epidemiology, and End Results Medicare data from 18 registries. Of the 6,044 enrolled patients with T2–T4 N0 M0 bladder cancer, 89.5% were White, 5.8% were non-Hispanic Black, 1.4% were Hispanic, and 3.3% were other.

The majority of Black patients with bladder cancer were located in Louisiana (19.0%), New Jersey (17.9%), and Georgia (17.6%). In New Jersey, Black patients with stage T2 disease appeared to have a higher risk of bladder cancer–specific mortality than White patients (adjusted hazard ratio = 1.74; P = .002). This finding seemed to hold true regardless of clinical management strategy: no curative treatment (adjusted hazard ratio = 1.61; P = .0168); radical cystectomy (adjusted hazard ratio = 2.05; P = .0039); and trimodal therapy (adjusted hazard ratio = 1.55; P = .0367).

Disclosure: No information regarding conflicts of interest was provided.



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