|The following article is part of conference coverage from the 2017 American Urological Association meeting in Boston. Renal and Urology News’ staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2017.|
BOSTON—Non-Hispanic blacks with metastatic bladder cancer are more likely to die from their disease compared with non-Hispanic whites, according to study findings presented at the American Urological Association 2017 annual meeting.
For a longitudinal study of health disparity, a team led by Stanley A. Yap, MD, MSc, of the University of California Davis Comprehensive Cancer Center in Sacramento used the California Cancer Registry to identify 3073 cases of metastatic bladder cancer. The study population included 2298 non-Hispanic whites, 192 non-Hispanic blacks, 383 Hispanics, 183 Asian/Pacific Islanders, and 17 patients of unknown or other race or ethnicity. The 2-year cancer-specific survival rate was 14.4% for non-Hispanic whites versus 6.5% for non-Hispanic blacks and 18.3% and 15.4% for Hispanics and Asian/Pacific Islander, respectively.
Compared with non-Hispanic whites (the reference group), non-Hispanic blacks had a significant 22% higher risk of dying from bladder cancer. The study found no significant difference in cancer-specific death risk between non-Hispanic whites and Hispanics and Asian/Pacific Islanders.
The 2-year survival rates also were lower among patients with lower socioeconomic status (SES). For example, patients in the lowest quintile of SES had a 2-year survival rate of 12.9%, whereas those in the highest quintile had a rate of 18%. In adjusted analyses, patients with lower SES were slightly more likely to die from their cancer, but this higher was not statistically significant.
“Disparities exist in both the treatment and survival of patients with metastatic bladder cancer,” Dr Yap told Renal & Urology News. “Groups particularly affected are non-Hispanic black patients and those with lower socioeconomic status. These remain important issues to address, especially given the lack of improvement in survival in this disease over the past 20 years.”
The study also found that patients treated with chemotherapy had a significantly better 2-year cancer-specific survival rate than those not treated with chemotherapy (20.8% vs 8.1%). Patients not treated with chemotherapy had a significant 2-fold increased risk of dying from bladder cancer compared with those who received chemotherapy.
Additionally, results showed that the 2-year survival rate declined with age from 17.2% for patients aged 20–64 years to 14.4% and 10.3% for those aged 65–79 years and 80 years and older, respectively. In adjusted analyses, patients aged 80 years and older had a significant 1.7 times higher risk of dying from metastatic bladder cancer than those aged 20–64 years.
Pan K, Klapheke A, Cress R, Yap S. A longitudinal study of health disparity in metastatic bladder cancer using the California Cancer Registry. [abstract] J Urol 2017;197(4S):e31. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12, 2017. Poster MP4-09.