Kumar Laksh, Ali Talha, Iqbal Faiqa, Ahmed Muhammad, Azeem Bazil
Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan.
Int Urol Nephrol. 2025 Apr 5. doi: 10.1007/s11255-025-04490-6.
Urinary tract cancers (UTCs), including bladder cancer, remain a significant public health challenge, particularly among individuals aged 75 and older. Despite declining bladder cancer-specific mortality rates between 2015 and 2020, the broader trends in UTC mortality and associated demographic disparities remain underexplored.
We analyzed mortality data from 1999 to 2022 using the CDC WONDER database. UTC deaths were identified using ICD- 10 codes C64 to C68. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, stratified by sex, race/ethnicity, and census regions. Joinpoint regression identified annual percent changes (APCs) to assess temporal trends.
From 1999 to 2022, 477,157 UTC deaths were recorded, 66% of which occurred among individuals aged 75 and older. The AAMR increased from 97.1 in 1999 to 103.5 in 2022, with a rise between 1999 and 2007 (APC: 0.63%), a decline from 2007 to 2019 (APC: - 0.33%), and a resurgence from 2019 to 2022 (APC: 2.42%). Older males exhibited higher AAMRs than females (178.7 vs. 53.6 in 2022), and Whites had the highest AAMR (108.5) among racial groups. The Western region recorded the highest AAMR (84.3) during the study period.
The resurgence in UTC mortality post- 2019 highlights emerging challenges, particularly among older males, Whites, and residents of the Western region. Targeted interventions, including improved screening and equitable healthcare access, are essential to mitigate these disparities and improve outcomes.
包括膀胱癌在内的泌尿系统癌症(UTCs)仍然是一项重大的公共卫生挑战,尤其是在75岁及以上的人群中。尽管2015年至2020年间膀胱癌特异性死亡率有所下降,但UTCs死亡率的总体趋势以及相关的人口统计学差异仍未得到充分研究。
我们使用疾病控制与预防中心(CDC)的WONDER数据库分析了1999年至2022年的死亡率数据。通过国际疾病分类第十版(ICD - 10)编码C64至C68确定UTCs死亡病例。计算每10万人口的年龄调整死亡率(AAMRs),并按性别、种族/族裔和普查区域进行分层。连接点回归确定年度百分比变化(APCs)以评估时间趋势。
1999年至2022年期间,共记录了477,157例UTCs死亡病例,其中66%发生在75岁及以上的人群中。AAMR从1999年的97.1上升至2022年的103.5,在1999年至2007年期间上升(APC:0.63%),2007年至2019年下降(APC: - 0.33%),2019年至2022年再次上升(APC:2.42%)。老年男性的AAMR高于女性(2022年为178.7对53.6),白人在种族群体中的AAMR最高(108.5)。在研究期间,西部地区的AAMR最高(84.3)。
2019年后UTCs死亡率的再次上升凸显了新出现的挑战,尤其是在老年男性、白人以及西部地区居民中。包括改进筛查和公平获得医疗保健在内的有针对性的干预措施对于减轻这些差异并改善结果至关重要。