Persistent Sex Disparities in Bladder Cancer Diagnosis, an Analysis of National Trends from 2012 to 2021.
Academic Article
Overview
abstract
PURPOSE: Women diagnosed with bladder cancer (BCa) are more likely to die of their disease as compared to men. Historical data suggests that this difference is in part due to delayed diagnosis, as the initial symptoms of BCa are often attributed to other causes including urinary tract infection (UTI). Whether efforts to address this disparity have resulted in improvements in time to diagnosis in women is unknown. MATERIALS AND METHODS: We used the Merative MarketScan Database to identify men and women diagnosed with BCa from January 2012 to December 2021 who had documented hematuria or UTI within the preceding year. The primary endpoint was time to BCa diagnosis following initial diagnosis of hematuria or UTI. RESULTS: A total of 12,667 patients with hematuria and 2,350 patients with UTIs were included in our study. Median time to diagnosis was similar for women compared to men when the presenting diagnosis was hematuria (35.0 days, IQR 14.0-79.8 vs. 33.0 days, IQR 14.0-69.0, p=0.005) and longer when the presenting diagnosis was a UTI (82.0 days, IQR 29.0-180.0 vs. 63.0 days, IQR 18.8-156.0, p<0.001). Women presenting with hematuria were more likely to receive a subsequent diagnosis of UTI (28% vs. 18%, p<0.001) before BCa diagnosis. Men were less likely to experience delays in diagnosis of >3 months (odds ratio 0.83, 95% CI 0.79-0.91). CONCLUSION: Women continue to experience delays in BCa diagnosis, especially following diagnosis with a UTI. Our findings suggest that this disparity is driven largely by clinical suspicion of UTI.
