Socioeconomic disparities in survival of patients with non-muscle invasive urothelial carcinoma.

Abstract

Purpose: Limited data are available on the impact of socioeconomic disparities on the survival of patients with non-muscle invasive urothelial carcinoma (NMIBC).

Methods: We analyzed the Surveillance, Epidemiology, and End Results database to review the effects of sex, race, location, and socioeconomic factors on the survival of patients with NMIBC. We calculated 5-year overall survival (OS) and cancer-specific survival (CSS) using the log-rank test. The impact of socioeconomic factors on OS and CSS was analyzed using the Cox proportional hazards model adjusted for clinical characteristics. Hazard ratios (HR) and survival rates were reported with 95% confidence intervals (CI).

Results: Analysis of 3831 patients showed that older age was associated with worse OS (HR 1.08 [1.08-1.09]) and CSS (HR 1.05 [1.04-1.06]). Women and men had similar OS (HR 0.91 [0.82-1.01]) and CSS (HR 1.12 [0.95-1.32]). Black patients had worse OS (HR 1.33 [1.08-1.62] and CSS [HR 1.54 [1.13-2.05]) than their White counterparts. Patients with an annual household income below $40,000 had worse outcomes compared to those with income above $70,000 for both OS (HR 1.79 [1.37-2.33]) and CSS (HR 1.924 [1.26-2.89]).

Conclusions: There were no gender differences in survival outcomes of NMIBC. Older age, Black, American Indian/Alaskan Native, and patients with a household income below $40,000 appear to have worse survival. However, the area of residence did not seem to affect patient survival.