Reading Hospital, West Reading, PA
Sachin Gupta , Monika Joshi , Xingran Weng , Li Wang
Background: Little is known about the patterns of racial and gender disparities in bladder cancer (BC). This study will use national large database to explore those disparities. Methods: Data from the National Cancer Institute’sSurveillance, Epidemiology, and End Results (SEER) Program for cancer registries was used. Patients > = 18 years diagnosed with BC in the years 2007-2016 were identified from SEER 18 database. We used the data year 2007 because that was the year when insurance status was first collected in SEER. Chi-square tests and multinomial logistic regression were used. Results: A total of 78,151 (females: 25.58%) patients were included, with 82.74% being non-Hispanic whites, 5.83% non-Hispanic blacks, 6.69 % Hispanics and 4.74% others. Distribution of stage 0 through stage IV at diagnosis was 51.97%, 23.21%, 12.11%, 4.10% and 8.61% respectively. Blacks (P < 0.0001) and females (P < 0.0001) were diagnosed at later stages as in Table. e.g., 14.54% of blacks were diagnosed at stage IV, compared to 7.97% of whites; and 11.03% of females at stage IV vs. 7.77% of males. Racial disparity exists for any given insurance status. Within every age group, gender disparity exists. For example, for those under 50 years of age, 12.81% of women vs. 8.16% of men were diagnosed at stage IV. After controlling for age, marital status and insurance type, both gender (P < 0.0001) and race (P < 0.0001) were statistically significant in predicting stage at diagnosis. Conclusions: Racial disparity in stage at BC diagnosis was strong, with blacks suffering most from the disparity. Females were more likely to be diagnosed at later stages, and this gender disparity exists in all age groups and was not due to women living longer. The existence of both racial and gender disparities in BC makes black women most vulnerable to late diagnosis than any other racial/gender group. Oncologists treating BC patients should be aware of the racial and gender disparity. More research needs to be done to help improve early access to health care amongst female and minority BC patients.
Stage at diagnosis | Gender (P < 0.0001) | Race (P < 0.0001) | ||||
---|---|---|---|---|---|---|
Male | Female | Non-Hispanic White | Non-Hispanic black | Hispanic | Other | |
Stage 0 | 52.97% | 49.06% | 53.13% | 40.70% | 50.51% | 47.64% |
Stage I | 24.17% | 20.44% | 23.07% | 23.79% | 22.90% | 25.43% |
Stage II | 11.34% | 14.36% | 11.96% | 14.96% | 11.09% | 12.78% |
Stage III | 3.75% | 5.11% | 3.86% | 6.02% | 4.51% | 5.19% |
Stage IV | 7.77% | 11.03% | 7.97% | 14.54% | 10.99% | 8.97% |
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