Improvements in Bladder Cancer Mortality in the US Are Not Equitably Distributed

An overall decrease in the incidence of bladder cancer mortality in the United States was not shared among micropolitan (rural) populations, revealing Black and rural populations experienced a significant worsening of mortality, presented at the 2022 ASCO Genitourinary Cancers Symposium.

“Bladder cancer is the most common malignancy of the urinary system. Advances in diagnosis, imaging, and treatments have led to improvements in bladder cancer management. Recent data demonstrate decreasing bladder cancer-specific mortality (BCSM) rates between 2014-2018 for both males and females,” wrote lead author Sophia C. Kamran, MD Massachusetts General Hospital, Boston, MA, lead author, and the other researchers. “However, these trends have not been further examined by race, ethnicity, or geographical location,” they wrote.

Therefore, the researchers compiled a comprehensive dataset of BCSM by obtaining age-adjusted mortality rates from 1999 to 2019 for bladder cancer (ICD10 code 67) for males and females of all ages in the US from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database. The authors then analyzed the data by race (White vs. Black), ethnicity (Hispanic vs. Non-Hispanic), urbanization category, and census region. Values < 0.05 were considered statistically significant.

The study determined that BCSM overall has decreased linearly by (-)0.0073 per 100,000 population/year (p <0.05). BCSM rates were significantly decreasing in all census regions (Northeast, Midwest, South, Midwest, p < 0.05). Evaluating by sex, both female [(-)0.131] and male [(-)0.022] BCSM rates decreased yearly (p < 0.05). By ethnicity, male Hispanic and female Non-Hispanic patients had significantly decreasing BCSM rates [(-)0.021 and (-)0.011, respectively, p < 0.05]. White patients had a slightly decreasing rate of BCSM [(-)0.0003, p = NS].

The gains do not appear to be universal, however. In micropolitan (rural) regions, the rate has increased yearly [(+)0.006] (p = 0.03). Additionally, Black patients had an increasing BCSM rate [(+)0.022, p < 0.05], the authors continued.

Improvements in BCSM are not equitable, investigators concluded.