Racial disparities in genitourinary cancer mortality trends in the United States, 2000-2020: A CDC database study.

Abstract

28 Background: Prostate, bladder, and kidney cancers account for substantial burden of cancer incidence and mortality in the United States. In 2020, an estimated 168,000 new cases and 32,000 deaths were attributed to these cancers. Studies examining racial disparities of mortality trends are needed. Methods: We utilized the CDC WONDER database to obtain mortality data for kidney, bladder, and prostate cancers between 2000-2020. Age-adjusted mortality rates per 100,000 persons were calculated and standardized to the Year 2000 US standard population. Rates were stratified by race, including White, Black, Asian/Pacific Islander (API), and American Indian/Alaska Native (AIAN). The National Cancer Institute Joinpoint Regression Program was utilized to calculate average annual percent changes (AAPCs). AAPCs were considered significant if the 95% confidence interval (CI) excluded zero. Results: Over the study period, 318,919 kidney cancer deaths, 150,613 bladder cancer deaths, and 516,508 prostate cancer deaths were identified. Between 2000-2020, amongst all races, mortality from prostate cancer (-1.8%; CI -2.0, -1.6), bladder cancer (-0.3%; CI -0.5, -0.2), and kidney cancer (-1.1%; CI -1.2, -0.9) all significantly declined. Considering racial disparities, prostate cancer mortality fell considerably in all race groups, most significantly among Black (-2.8%, CI -3.2%, -2.4%) and AIAN (-2.4%, CI -2.9%, -1.8%) populations, outpacing reductions in API (-1.7%, CI -2.6%, -0.8%) and White (-1.6%, CI -1.9%, -1.4%) populations. In bladder cancer, the decline in mortality was statistically significant for Black (AAPC: -0.8%, CI -1.1%, -0.6%) and for White, (-0.4%, CI -0.6%, -0.1%), but not for API individuals (-0.3%, CI -0.9%, 0.3%). For kidney cancer, mortality dropped substantially across all examined races, with the steepest decline seen in Black (-1.4%, CI -1.7%, -1.2%) and AIAN (-1.7%, CI -2.5%, -1.0%) compared to White (-1.0%, CI -1.2%, -0.9%) and API (-1.4%, CI -4.2%, 1.6%, non-significant) population. Conclusions: This study represents the most comprehensive population database analysis assessing GU cancer mortality trends. While an overall decline in GU cancer mortality was observed, which was comparatively greater for Black Americans over the past two decades, significant racial disparities continue to persist. Focused and targeted efforts are essential to address these disparities. [Table: see text]