Racial Disparities and Access to Care in Bladder Cancer
Posted: Tuesday, March 16, 2021
There appeared to be no differences in survival outcomes within the Veterans Affairs system when comparing Black and White patients with bladder cancer. However, differences did exist when looking at data from the Surveillance, Epidemiology, and End Results (SEER) database. This study, which was presented during the virtual 2021 Genitourinary (GU) Cancers Symposium (Abstract 399) by Brent Rose, MD, of the University of California, San Diego, suggests additional research is needed to explore these disparities and guide appropriate strategies for screening.
“Our study highlights the beneficial impact of an equal access health-care system in reducing financial and social barriers to health care to counteract racial health disparities,” concluded the authors.
This retrospective study was conducted using data from the Veterans Affairs Informatics and Computing Infrastructure and SEER. Researchers collected information on all patients with a diagnosis of bladder cancer between 2000 and 2018. This led to the identification of 36,322 veterans with bladder cancer in the Veterans Affairs system; 91% were White and 9% were Black. An additional 130,998 patients (5.9% were Black and 94.1% were White) were identified from the SEER database.
The Black patients in the Veterans Affairs database were more likely to have more comorbidities and reside in zip codes with lower median income and education levels when compared with their White counterparts. Black patients presented with stage 2 to 4 bladder cancer 23.3% of the time, compared with 19% in White patients. However, multivariate models were used to control for disease stage and other comorbidities. These analyses revealed no statistically significant differences in overall survival (hazard ratio = 1.00), bladder cancer–specific survival (hazard ratio = 1.01), and non–bladder cancer–specific survival (hazard ratio = 0.96).
When the SEER data were analyzed, Black patients had inferior outcomes compared with White patients, including a decrease in overall survival (hazard ratio = 1.32), bladder cancer–specific survival (hazard ratio = 1.31), and non–bladder cancer–specific survival (hazard ratio = 1.18).
Disclosure: For a full list of author disclosures, visit coi.asco.org.