MP59-08 DISPARITIES IN THE PREVALENCE AND MANAGEMENT OF HIGH-RISK NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyCME1 May 2022MP59-08 DISPARITIES IN THE PREVALENCE AND MANAGEMENT OF HIGH-RISK NON-MUSCLE INVASIVE BLADDER CANCER Angela Estevez, Sumedh Kaul, Aaron Fleishman, Ruslan Korets, Peter Chang, Andrew Wagner, Joaquim Bellmunt, Aria Olumi, Heidi Rayala, and Boris Gershman Angela EstevezAngela Estevez More articles by this author , Sumedh KaulSumedh Kaul More articles by this author , Aaron FleishmanAaron Fleishman More articles by this author , Ruslan KoretsRuslan Korets More articles by this author , Peter ChangPeter Chang More articles by this author , Andrew WagnerAndrew Wagner More articles by this author , Joaquim BellmuntJoaquim Bellmunt More articles by this author , Aria OlumiAria Olumi More articles by this author , Heidi RayalaHeidi Rayala More articles by this author , and Boris GershmanBoris Gershman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002642.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Substantial variation exists in the management of non-muscle-invasive bladder cancer (NMIBC) despite strong clinical practice guidelines. We hypothesized that socioeconomic disparities may be associated with variation in the management of NMIBC, and utilized a nationwide oncology dataset to examine this question. METHODS: We identified adult patients aged 18-89 years with Ta, T1, or Tis urothelial carcinoma of the bladder diagnosed from 2006-2016 in the NCDB. We then examined the associations of patient and socioeconomic characteristics with the guidelines-based management of high-risk NMIBC using multivariable logistic regression. RESULTS: A total of 163,949 patients were included in the study cohort, including 64% with Ta, 32% with T1, and 4% with Tis disease. Among those diagnosed with bladder cancer, male (OR 1.24, 95%CI 1.21-1.27), uninsured (OR 1.10, 95%CI 1.01-1.19 vs private), and non-White (OR 1.34, 95%CI 1.28-1.41 for Black; OR 1.10; 95%CI 1.03-1.18 for Other versus White) patients were more likely to be diagnosed with high-risk (HGT1 or Tis) disease, as well as patients from lower education level areas. Among those with high-risk NMIBC, patients who were older, non-White, Hispanic, uninsured or insured with Medicaid were less likely to receive intravesical BCG, while those residing in rural and higher education level areas were more likely to receive BCG (Table 1). When examining non-guidelines based use of radiotherapy for HGT1 disease, older age (OR 1.06; 95% CI 1.04-1.07) and VA/Military insurance (OR 2.73; 95%CI 0.93-6.36 vs private) were associated with radiotherapy use. CONCLUSIONS: There are strong disparities in the prevalence and management of high-risk NMIBC. These observations represent an important target for future efforts to identify interventions to reduce such healthcare disparities. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e1004 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Angela Estevez More articles by this author Sumedh Kaul More articles by this author Aaron Fleishman More articles by this author Ruslan Korets More articles by this author Peter Chang More articles by this author Andrew Wagner More articles by this author Joaquim Bellmunt More articles by this author Aria Olumi More articles by this author Heidi Rayala More articles by this author Boris Gershman More articles by this author Expand All Advertisement PDF DownloadLoading ...