MP22-02 THE IMPACT OF RURAL RESIDENCY ON THE TREATMENT AND OUTCOMES OF LOCALLY INVASIVE/ADVANCED BLADDER CANCER IN LOUISIANA

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP22-02 THE IMPACT OF RURAL RESIDENCY ON THE TREATMENT AND OUTCOMES OF LOCALLY INVASIVE/ADVANCED BLADDER CANCER IN LOUISIANA Megan Escott, Tingting Li, Mei-Chin Hsieh, Scott Delacroix, Jessie Gills, Xiao-Cheng Wu, and Mary Westerman Megan EscottMegan Escott More articles by this author , Tingting LiTingting Li More articles by this author , Mei-Chin HsiehMei-Chin Hsieh More articles by this author , Scott DelacroixScott Delacroix More articles by this author , Jessie GillsJessie Gills More articles by this author , Xiao-Cheng WuXiao-Cheng Wu More articles by this author , and Mary WestermanMary Westerman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003247.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A later stage at diagnosis, gender, and race are independent predictors of bladder cancer-specific survival. There remains a need, however, to investigate additional contributors. We investigated the effect of urban and rural residency on a patient’s likelihood to receive standard of care in Louisiana and its impact on cancer-specific and overall survival. METHODS: Using the Louisiana Tumor Registry, we identified microscopically confirmed AJCC stage II – III bladder cancer diagnoses between 2014 and 2018. Multivariable logistic regression, Kaplan-Meier method, and Multivariate Cox proportional hazard analysis was performed. RESULTS: We identified 704 patients, with 75% having AJCC stage two disease. 598 (85%) patients lived in urban settings and 106 (15%) patients lived in rural settings. After controlling for race, socioeconomic status, and insurance coverage, there was no significant difference in the probability of urban and rural residents receiving the standard of care for definitive management. However, rural residency was independently associated with an increased risk of cancer-specific mortality (Figure 1). The median overall survival for residents of urban areas was 27 months (95% CI [23, 33]) compared to 13 months (95% CI [10, 20]) for residents of rural areas (Figure 2). CONCLUSIONS: A recent study using national census data called for further epidemiologic investigations after finding that patients with bladder cancer who lived in rural areas had significantly higher overall mortality and marginally increased cancer-specific mortality. Despite all Louisiana residents receiving the standard of care for definitive management of locally invasive bladder cancer, rural patients still had increased risks of cancer-specific and overall mortality after controlling for several demographic factors, only highlighting the need for continued investigation into disparities in bladder cancer outcomes. Source of Funding: NCI’s Surveillance, Epidemiology, End Result (SEER): HHSN261201800007I/HHSN26100002. CDC’s National Program Cancer Registries (NPCR): NU58DP006332 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e295 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Megan Escott More articles by this author Tingting Li More articles by this author Mei-Chin Hsieh More articles by this author Scott Delacroix More articles by this author Jessie Gills More articles by this author Xiao-Cheng Wu More articles by this author Mary Westerman More articles by this author Expand All Advertisement PDF downloadLoading ...