Disparities in Bladder Cancer Outcomes Based on Key Sociodemographic Characteristics
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UROTHELIAL CANCER (S DANESHMAND, SECTION EDITOR)
Disparities in Bladder Cancer Outcomes Based on Key Sociodemographic Characteristics Wesley Yip 1 & Giovanni Cacciamani 1 & Sumeet K. Bhanvadia 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review A review of the impact of several key patient characteristics on oncologic outcomes in bladder cancer (BC) summarized and analyzed in a narrative fashion. Recent Findings The bulk of the published literature suggests that females and blacks have poorer cancer-specific outcomes. Both groups tend to present with worse disease, which may be driven by differences in access to timely and quality care. Attempts to assess the association between smoking status and history and BC outcomes have been hindered by the quality and heterogeneity of the data, although several studies have linked smoking with higher rates of recurrence and poorer survival. Being married, particularly in men, may improve survival after radical cystectomy (RC). Limited data suggests that socioeconomic and education levels may be associated with poorer survival; however, the data is limited. Summary A growing body of investigation suggests that there are significant differences in oncologic outcomes in BC patients based on race, gender, smoking status, socioeconomic status, and others. Further focus and investigation is needed to validate these findings, investigate the root cause of these differences, and offer solutions to mitigate them. Keywords Urothelial bladder cancer . Genitourinary malignancy . Oncologic outcomes
Introduction Urothelial bladder cancer (BC) is the second most common genitourinary malignancy, and the most aggressive. Overall, roughly two thirds of patients will present with non-muscleinvasive disease, of which up to 60% of those in the high-risk group will progress to muscle-invasive disease despite treatment. Of the one third of patients who will initially be diagnosed with muscle-invasive disease, the standard of care (SOC) is radical cystectomy (RC) versus tri-modal therapy. Up to 50% of these patients will develop metastatic disease, a number that is comprised of those who did and did not get SOC treatment [1]. Various sociodemographic factors have been investigated as they pertain to cancer outcomes in BC. While This article is part of the Topical Collection on Urothelial Cancer * Sumeet K. Bhanvadia [email protected] 1
USC Institute of Urology, Keck School of Medicine, USC/Norris Comprehensive Cancer Center, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA 90033, USA
the prevalence of BC is highest in white males, there appear to be inferior outcomes amongst women and blacks with BC. A growing body of literature has explored this through both large and small data sets, and through the lens of access to care, quality of care, delays in diagnosis, variation in response to treatment, and other unknown factors. Similarly, the impact of smoking status and marital status has been associated with disparities in oncologic outcomes. More rec
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