Transitional Cell Carcinoma of the Bladder: Racial and Gender Disparities in Survival (1993 to 2002), Stage and Grade (1993 to 2007)

No AccessJournal of UrologyAdult Urology1 May 2011Transitional Cell Carcinoma of the Bladder: Racial and Gender Disparities in Survival (1993 to 2002), Stage and Grade (1993 to 2007) Katherine Mallin, Kevin A. David, Peter R. Carroll, Matthew I. Milowsky, and David M. Nanus Katherine MallinKatherine Mallin American College of Surgeons, Chicago, Illinois More articles by this author , Kevin A. DavidKevin A. David Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey More articles by this author , Peter R. CarrollPeter R. Carroll Department of Medicine and Urology, University of California-San Francisco, San Francisco, California More articles by this author , Matthew I. MilowskyMatthew I. Milowsky Department of Medicine, Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author , and David M. NanusDavid M. Nanus Department of Medicine and Urology, Weill Cornell Medical College of Cornell University, New York, New York More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.12.049AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Bladder cancer survival is consistently lower in female and black patients than in male and white patients. We compared trends and differences according to clinical, demographic and facility characteristics by patient race and gender to identify the impact of these characteristics on survival. Materials and Methods: We identified bladder transitional cell carcinoma cases diagnosed in 1993 to 2007 from the National Cancer Data Base. Trends in grade and stage distribution between 1993 and 2007 were analyzed. Survival differences by race and gender were compared using 5-year relative survival and multivariate Cox regression. Results: There were 310,257 white male, 102,345 white female, 13,313 black male and 7,439 black female patients. Black and female patients had a higher proportion of muscle invasive tumors than white and male patients, and black patients had a larger proportion of higher grade tumors. The incidence of stage 0a and of high grade tumors significantly increased with time. Multivariate analysis showed a significantly lower HR in white females than in white males (HR 0.9) but a significantly higher HR in black males and females (HR 1.2). The higher mortality risk in black males and females was primarily limited to late stage disease (HR 1.3). Conclusions: Survival differences by race and gender are partially explained by differences in tumor and demographic characteristics in black males and females, and fully explained by these characteristics in white females. Treatment delays and under treatment due to comorbid conditions, age and other factors may also contribute to these disparities. 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Volume 185Issue 5May 2011Page: 1631-1636 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordstransitional cellcarcinomaurinary bladdersexEuropean continental ancestry groupAfrican continental ancestry groupMetricsAuthor Information Katherine Mallin American College of Surgeons, Chicago, Illinois More articles by this author Kevin A. David Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey More articles by this author Peter R. Carroll Department of Medicine and Urology, University of California-San Francisco, San Francisco, California More articles by this author Matthew I. Milowsky Department of Medicine, Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York More articles by this author David M. Nanus Department of Medicine and Urology, Weill Cornell Medical College of Cornell University, New York, New York More articles by this author Expand All Advertisement PDF downloadLoading ...