Bladder cancer: worse survival in women from deprived areas

Moran, Anthony; Sowerbutts, Anne Marie; Collins, Stuart; Clarke, Noel W.; Cowan, Richard

doi:10.1038/sj.bjc.6601847

Cited by 12 publications

(11 citation statements)

References 5 publications

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“…Research has highlighted a synergistic association of female sex combined with higher deprivation and lower treatment use [20]. However, in the present study the interaction between deprivation and sex was not significant.…”

Section: Discussioncontrasting

confidence: 96%

“…We detected a significant though small gender gap in radiotherapy use. Like previous investigators [20,[22][23][24] we found that women with bladder UCC tend to present at a more advanced stage, but gender differences in radiotherapy use persisted even when the analysis was adjusted for stage. Therefore, factors other than stage must be responsible and should be explored in future research.…”

Section: Discussionsupporting

confidence: 85%

“…Nevertheless, it is unlikely that the extent of observed gender differences in radiotherapy use could fully account for gender differences in survival, which are more substantial [5]. Research has highlighted a synergistic association of female sex combined with higher deprivation and lower treatment use [20]. However, in the present study the interaction between deprivation and sex was not significant.…”

Section: Discussioncontrasting

confidence: 74%

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Trends in the use of radiotherapy and radical surgery for patients with bladder urothelial cell carcinoma in East Anglia, 1995–2006

et al. 2011

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Study Type – Prevalence (retrospective cohort) Level of Evidence 2b What’s known on the subject? and What does the study add? In the UK, specialist services for the management of urological cancers have been reconfigured substantially in recent time periods. Socioeconomic inequalities in relative survival from bladder cancer have also been documented. In part of an English region, use of radical surgery to manage the most common type of bladder cancer increased and use of radiotherapy decreased during 1995–2006, most probably reflecting increasing availability of specialist surgical management. There was no evidence for differences in the use of radiotherapy or radical surgery between patients of different socio‐economic groups. OBJECTIVE To examine the use of radiotherapy and radical surgery for bladder urothelial cell carcinoma (UCC) before, during and after national initiatives for reorganization of uro‐oncology services. PATIENTS AND METHODS Population‐based data (1995–2006) from a cancer registry with stable coding practices were analysed. Bladder UCC was defined using relevant International Classification of Disease site and morphology codes. Time trends in the use of radiotherapy and radical surgery, and other predictors of their use were examined. RESULTS Of 4639 bladder UCC patients aged ≥40 years (76% men), stage information was available for 4303 (93%). Morphology and stage case mix remained stable during the study period. Radiotherapy use decreased significantly (from 31% in 1995–1998 to 22% in 2003–2006, P < 0.001) among patients of any stage, whilst radical surgery use increased significantly (from 8 to 13%, P < 0.001), particularly among stage II–IV patients. The proportion of patients treated by both radiotherapy and surgery also decreased notably (from 4.0 to 1.1%). Women were significantly more likely to present in stages II–IV [odds ratio (OR) = 1.22, 95% confidence interval (CI) = 1.06–1.40, P= 0.005], and less likely to be treated with radiotherapy (OR = 0.84, 95% CI: 0.72–0.99, P= 0.036). CONCLUSIONS Use of radical surgery in UCC invading bladder muscle increased and use of radiotherapy decreased during the study period, most probably reflecting the increasing availability of specialist surgical management. Sociodemographic variation in treatment was limited to lower use of radiotherapy in women. Further research should encompass treatment timeliness and other aspects of care quality, as well as exploring potential differences in endoscopic treatments for disease not invading bladder muscle.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 74%

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Trends in the use of radiotherapy and radical surgery for patients with bladder urothelial cell carcinoma in East Anglia, 1995–2006

et al. 2011

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“…However, the difference reduced after six months. [20] According to WHO, the survival accumulation at the end of five years in Thai females and males suffering from the bladder cancer has been equal to 39 and 61.5% respectively. Nevertheless, the survival accumulation at the end of five years in female and male patients from Madras, India has been reported as 15 and 25% respectively.…”

Section: Discussionmentioning

confidence: 99%

Survival analysis of patients with bladder cancer, life table approach

et al. 2012

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Background:Bladder cancer is the fourth most common malignancy in men and the eighth most common in women. It causes 8% of all malignancies in men and 3% of all malignancies in women. The trend of bladder cancer is increasing in Iran. This study was conducted to estimate the survival rate of bladder cancer based on life table method.Materials and Methods:In this study, at first, data were collected based on individual variables of 514 patients suffering from bladder cancer and referred them to cancer registry center of Shiraz University of Medical Sciences from 2001-2009. Data were collected at two stages and analyzed by life table method and Wilcox on test. Significant level considered at 0.05.Results:Our findings showed that probability of survival accumulation at the end of 1, 3, 5, 10 years in patients with bladder cancer were equal to 0.8989, 0.7132, 0.5752 and 0.2459 respectively. There was significant difference in survival rate among age groups and treatment types (P < 0.05). However, we did not observe any difference in survival time based on smoking (P = 0.578), alcohol (P = 0.419) and education level (P = 0.371) of patients.Conclusion:The overall survival rate of bladder cancer in the present study was less than other areas. Patients’ age and treatment type were the influential factor in survival time. So continuous screening for early diagnosis suggested for older people.

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“…There is an increasing body of knowledge that has highlighted the association of poorer outcomes with socioeconomic status and increased mortality from various cancers [2,3]. In bladder UC, several studies have shown some form of survival disparity from bladder UC associated with SES [1,[4][5][6][7][8][9][10]. Most of these studies had the primary endpoint of all-cause mortality, a measure that may be associated with SES regardless of the diagnosis of bladder cancer.…”

Section: Introductionmentioning

confidence: 99%

Disparities in overall and urothelial carcinoma specific mortality associated with healthcare insurance status

Siddiqui

Heney

McDougal

et al. 2015

Bladder

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OBJECTIVE:We investigated the association of insurance status with urothelial carcinoma (UC) mortality outcomes to further understand the relationship of socioeconomic status (SES) and UC disease outcomes. MATERIALS AND METHODS:We performed an IRB approved, retrospective review of patients newly diagnosed with bladder UC in the years 2004 and 2005. Data were collected from January 2004 to September 2014 regarding insurance, demographics, operations, surgical pathology, and follow-up care. Insurance was characterized as lower SES and high SES based on election to utilize private vs. public sources as well as purchase of supplemental Medicare coverage. RESULTS:A total of 213 patients were examined with a mean follow-up of 84 months. The high SES and lower SES insurance groups presented with similar disease stage (26% ≥ T2 in high SES insurance vs. 33%, P = 0.1) and grade (60% high-grade in high SES vs. 59%, P = 0.9). Significant differences were seen in one-year UC specific mortality (5% high SES insurance vs. 21%, P = 0.003) and five-year UC specific mortality (19% high SES insurance vs. 42%, P = 0.007). Upon multivariate analysis controlling for age, gender, Charlson comorbidity score, grade, stage, and metastatic disease on presentation, insurance type remained a significant risk factor for increased mortality from UC (HR = 2.6, P < 0.01). Kaplan-Meier analysis showed a persistence of lower survival with time. CONCLUSIONS:We found disparities in mortality from bladder cancer associated with source of insurance. This association persisted upon multivariate analysis as an independent risk factor for death from bladder UC.

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Bladder cancer: worse survival in women from deprived areas

Cited by 12 publications

References 5 publications

Trends in the use of radiotherapy and radical surgery for patients with bladder urothelial cell carcinoma in East Anglia, 1995–2006

Trends in the use of radiotherapy and radical surgery for patients with bladder urothelial cell carcinoma in East Anglia, 1995–2006

Survival analysis of patients with bladder cancer, life table approach

Disparities in overall and urothelial carcinoma specific mortality associated with healthcare insurance status

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