Bladder cancer: Race differences in extent of disease at diagnosis

George R. Prout, Margaret N. Wesley, Raymond S. Greenberg, Vivien W. Chen, Charles C. Brown, Alex W. Miller, Ronald S Weinstein, Stanley J. Robboy, M. Alfred Haynes, Robert S. Blacklow, Brenda K. Edwards

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

BACKGROUND. Blacks are less likely than whites to develop bladder cancer; although once diagnosed, blacks experience poorer survival. This study sought to examine multiple biological and behavioral factors and their influence on extent of disease. METHODS. A population-based cohort of black bladder cancer patients and a random sample of frequency-matched white bladder cancer patients, stratified by age, gender, and race were identified through cancer registry systems in metropolitan Atlanta, New Orleans, and the San Francisco/Oakland area. Patients were ages 20-79 years at bladder cancer diagnosis from 1985-1987, and had no previous cancer history. Medical records were reviewed at initial diagnosis. Of the patients selected for study, a total of 77% of patients was interviewed. Grade, stage, and other variables (including age, socioeconomic status, symptom duration, and smoking history) were recorded. Extent of disease was modeled in 497 patients with urothelial carcinoma using logistic regression. RESULTS. Extent of disease at diagnosis was significantly greater in Blacks than in Whites. Older age group, higher tumor grade, larger tumors, and presence of carcinoma in situ were related to greater extent of disease in blacks and in whites. Large disparities between blacks and whites were found for socioeconomic status and source of care. Blacks had greater symptom duration and higher grade. Black women were more likely to have invasive disease than white women; this difference was not seen among men. Blacks in unskilled occupational categories, perhaps reflecting socioeconomic factors, were at much higher risk for muscle invasion than whites. CONCLUSIONS. While specific relationships between variables were noted, an overall pattern defining black and white differences in stage did not emerge. Future studies should examine the basis upon which occupation and life style factors operate by using biochemical and molecular methods to study the genetic factors involved.

Original languageEnglish (US)
Pages (from-to)1349-1358
Number of pages10
JournalCancer
Volume89
Issue number6
DOIs
StatePublished - Sep 15 2000

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Urinary Bladder Neoplasms
Social Class
Neoplasms
San Francisco
Carcinoma in Situ
Biological Factors
Occupations
Medical Records
Registries
Life Style
Age Groups
Logistic Models
Smoking
History
Carcinoma
Muscles
Survival
hydroquinone
Population

Keywords

  • Bladder cancer
  • Cancer registry
  • Grade
  • Race
  • Sociodemographic factors
  • Stage

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Prout, G. R., Wesley, M. N., Greenberg, R. S., Chen, V. W., Brown, C. C., Miller, A. W., ... Edwards, B. K. (2000). Bladder cancer: Race differences in extent of disease at diagnosis. Cancer, 89(6), 1349-1358. https://doi.org/10.1002/1097-0142(20000915)89:6<1349::AID-CNCR20>3.0.CO;2-D

Bladder cancer : Race differences in extent of disease at diagnosis. / Prout, George R.; Wesley, Margaret N.; Greenberg, Raymond S.; Chen, Vivien W.; Brown, Charles C.; Miller, Alex W.; Weinstein, Ronald S; Robboy, Stanley J.; Haynes, M. Alfred; Blacklow, Robert S.; Edwards, Brenda K.

In: Cancer, Vol. 89, No. 6, 15.09.2000, p. 1349-1358.

Research output: Contribution to journalArticle

Prout, GR, Wesley, MN, Greenberg, RS, Chen, VW, Brown, CC, Miller, AW, Weinstein, RS, Robboy, SJ, Haynes, MA, Blacklow, RS & Edwards, BK 2000, 'Bladder cancer: Race differences in extent of disease at diagnosis', Cancer, vol. 89, no. 6, pp. 1349-1358. https://doi.org/10.1002/1097-0142(20000915)89:6<1349::AID-CNCR20>3.0.CO;2-D
Prout GR, Wesley MN, Greenberg RS, Chen VW, Brown CC, Miller AW et al. Bladder cancer: Race differences in extent of disease at diagnosis. Cancer. 2000 Sep 15;89(6):1349-1358. https://doi.org/10.1002/1097-0142(20000915)89:6<1349::AID-CNCR20>3.0.CO;2-D
Prout, George R. ; Wesley, Margaret N. ; Greenberg, Raymond S. ; Chen, Vivien W. ; Brown, Charles C. ; Miller, Alex W. ; Weinstein, Ronald S ; Robboy, Stanley J. ; Haynes, M. Alfred ; Blacklow, Robert S. ; Edwards, Brenda K. / Bladder cancer : Race differences in extent of disease at diagnosis. In: Cancer. 2000 ; Vol. 89, No. 6. pp. 1349-1358.
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abstract = "BACKGROUND. Blacks are less likely than whites to develop bladder cancer; although once diagnosed, blacks experience poorer survival. This study sought to examine multiple biological and behavioral factors and their influence on extent of disease. METHODS. A population-based cohort of black bladder cancer patients and a random sample of frequency-matched white bladder cancer patients, stratified by age, gender, and race were identified through cancer registry systems in metropolitan Atlanta, New Orleans, and the San Francisco/Oakland area. Patients were ages 20-79 years at bladder cancer diagnosis from 1985-1987, and had no previous cancer history. Medical records were reviewed at initial diagnosis. Of the patients selected for study, a total of 77{\%} of patients was interviewed. Grade, stage, and other variables (including age, socioeconomic status, symptom duration, and smoking history) were recorded. Extent of disease was modeled in 497 patients with urothelial carcinoma using logistic regression. RESULTS. Extent of disease at diagnosis was significantly greater in Blacks than in Whites. Older age group, higher tumor grade, larger tumors, and presence of carcinoma in situ were related to greater extent of disease in blacks and in whites. Large disparities between blacks and whites were found for socioeconomic status and source of care. Blacks had greater symptom duration and higher grade. Black women were more likely to have invasive disease than white women; this difference was not seen among men. Blacks in unskilled occupational categories, perhaps reflecting socioeconomic factors, were at much higher risk for muscle invasion than whites. CONCLUSIONS. While specific relationships between variables were noted, an overall pattern defining black and white differences in stage did not emerge. Future studies should examine the basis upon which occupation and life style factors operate by using biochemical and molecular methods to study the genetic factors involved.",
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N2 - BACKGROUND. Blacks are less likely than whites to develop bladder cancer; although once diagnosed, blacks experience poorer survival. This study sought to examine multiple biological and behavioral factors and their influence on extent of disease. METHODS. A population-based cohort of black bladder cancer patients and a random sample of frequency-matched white bladder cancer patients, stratified by age, gender, and race were identified through cancer registry systems in metropolitan Atlanta, New Orleans, and the San Francisco/Oakland area. Patients were ages 20-79 years at bladder cancer diagnosis from 1985-1987, and had no previous cancer history. Medical records were reviewed at initial diagnosis. Of the patients selected for study, a total of 77% of patients was interviewed. Grade, stage, and other variables (including age, socioeconomic status, symptom duration, and smoking history) were recorded. Extent of disease was modeled in 497 patients with urothelial carcinoma using logistic regression. RESULTS. Extent of disease at diagnosis was significantly greater in Blacks than in Whites. Older age group, higher tumor grade, larger tumors, and presence of carcinoma in situ were related to greater extent of disease in blacks and in whites. Large disparities between blacks and whites were found for socioeconomic status and source of care. Blacks had greater symptom duration and higher grade. Black women were more likely to have invasive disease than white women; this difference was not seen among men. Blacks in unskilled occupational categories, perhaps reflecting socioeconomic factors, were at much higher risk for muscle invasion than whites. CONCLUSIONS. While specific relationships between variables were noted, an overall pattern defining black and white differences in stage did not emerge. Future studies should examine the basis upon which occupation and life style factors operate by using biochemical and molecular methods to study the genetic factors involved.

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