Department of Surgery, University of Utah, Salt Lake City, Utah, USA.
Urology. 2011 Sep;78(3):544-9. doi: 10.1016/j.urology.2011.02.042. Epub 2011 Jul 22.
To examine trends in bladder cancer survival among whites, blacks, Hispanics, and Asian/Pacific Islanders in the United States over a 30-year period. Racial disparities in bladder cancer outcomes have been documented with poorer survival observed among blacks. Bladder cancer outcomes in other ethnic minority groups are less well described.
From the Surveillance, Epidemiology and End Results cancer registry data, we identified patients diagnosed with transitional cell carcinoma of the bladder between 1975 and 2005. This cohort included 163,973 white, 7731 black, 7364 Hispanic, and 5934 Asian/Pacific Islander patients. We assessed the relationship between ethnicity and patient characteristics. Disease-specific 5-year survival was estimated for each ethnic group and for subgroups of stage and grade.
Blacks presented with higher-stage disease than whites, Hispanics, and Asian/Pacific Islanders, although a trend toward earlier-stage presentation was observed in all groups over time. Five-year disease-specific survival was consistently worse for blacks than for other ethnic groups, even when stratified by stage and grade. Five-year disease-specific survival was 82.8% in whites compared with 70.2% in blacks, 80.7% in Hispanics, and 81.9% in Asian/Pacific Islanders. There was a persistent disease-specific survival disadvantage in black patients over time that was not seen in the other ethnic groups.
Ethnic disparities in bladder cancer survival persist between whites and blacks, whereas survival in other ethnic minority groups appears similar to that of whites. Further study of access to care, quality of care, and treatment decision making among black patients is needed to better understand these disparities.
在美国，研究白人、黑人、西班牙裔和亚洲/太平洋岛民在 30 年内膀胱癌生存趋势。有文献记载，膀胱癌的结局存在种族差异，黑人的生存率较低。其他少数族裔群体的膀胱癌结局描述较少。
从监测、流行病学和最终结果癌症登记处的数据中，我们确定了 1975 年至 2005 年间诊断为移行细胞膀胱癌的患者。该队列包括 163973 名白人、7731 名黑人、7364 名西班牙裔和 5934 名亚洲/太平洋岛民患者。我们评估了种族与患者特征之间的关系。估计了每个种族群体以及分期和分级亚组的疾病特异性 5 年生存率。
与白人、西班牙裔和亚洲/太平洋岛民相比，黑人的疾病分期更高，尽管所有人群的疾病分期均呈逐渐早期的趋势。即使按分期和分级分层，黑人的 5 年疾病特异性生存率也始终比其他种族群体差。白人的 5 年疾病特异性生存率为 82.8%，黑人的为 70.2%，西班牙裔的为 80.7%，亚洲/太平洋岛民的为 81.9%。黑人患者的疾病特异性生存率持续存在劣势，而其他种族群体则没有这种情况。
白人患者和黑人患者之间的膀胱癌生存存在种族差异，而其他少数族裔群体的生存情况似乎与白人相似。需要进一步研究黑人患者的医疗保健获取、医疗保健质量和治疗决策，以更好地理解这些差异。
