Sociodemographic disparities in chemotherapy treatment and impact on survival among patients with metastatic bladder cancer

Amy Klapheke, Stanley Yap, Kevin Pan, Rosemary D Cress

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To evaluate how socioeconomic status and other demographic factors are associated with the receipt of chemotherapy and subsequent survival in patients diagnosed with metastatic bladder cancer. Methods: Using data from the California Cancer Registry, we identified 3,667 patients diagnosed with metastatic urothelial carcinoma of the urinary bladder between 1988 and 2014. The characteristics of patients who did and did not receive chemotherapy as part of the first course of treatment were compared using chi-square tests. Logistic regression was used to identify predictors of chemotherapy treatment. Fine and Gray competing-risks regression and Cox proportional hazards regression were used to estimate bladder cancer-specific and all-cause mortality, respectively. Results: Less than half (46.3%) of patients received chemotherapy. Patients from the lowest socioeconomic quintile were half as likely to have chemotherapy as those from highest quintile (odds ratio = 0.5, 95% CI: 0.4, 0.7). Unmarried patients were significantly less likely to receive treatment (odds ratio = 0.6, 95% CI: 0.5, 0.7). Not receiving chemotherapy was associated with greater mortality from bladder cancer (subdistribution hazard ratio = 1.4, 95% CI: 1.3, 1.5) and from all causes (hazard ratio = 2.0, 95% CI: 1.8, 2.1). Conclusions: We found clear disparities in chemotherapy treatment and survival with respect to socioeconomic and marital status. Future studies should explore the possible reasons why patients with low socioeconomic status and who are unmarried are less likely to have chemotherapy.

Original languageEnglish (US)
Pages (from-to)308.e19-308.e25
JournalUrologic Oncology: Seminars and Original Investigations
Volume36
Issue number6
DOIs
StatePublished - Jun 1 2018

Fingerprint

Urinary Bladder Neoplasms
Drug Therapy
Survival
Social Class
Therapeutics
Odds Ratio
Mortality
Marital Status
Chi-Square Distribution
Registries
Urinary Bladder
Logistic Models
Demography
Carcinoma
Neoplasms

Keywords

  • Cancer
  • Chemotherapy
  • Drug therapy
  • Epidemiology
  • Neoplasm metastasis
  • Urinary bladder neoplasms

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

@article{d5fc05d5057d4d8ca25cd3da80e6bc7d,
title = "Sociodemographic disparities in chemotherapy treatment and impact on survival among patients with metastatic bladder cancer",
abstract = "Objective: To evaluate how socioeconomic status and other demographic factors are associated with the receipt of chemotherapy and subsequent survival in patients diagnosed with metastatic bladder cancer. Methods: Using data from the California Cancer Registry, we identified 3,667 patients diagnosed with metastatic urothelial carcinoma of the urinary bladder between 1988 and 2014. The characteristics of patients who did and did not receive chemotherapy as part of the first course of treatment were compared using chi-square tests. Logistic regression was used to identify predictors of chemotherapy treatment. Fine and Gray competing-risks regression and Cox proportional hazards regression were used to estimate bladder cancer-specific and all-cause mortality, respectively. Results: Less than half (46.3{\%}) of patients received chemotherapy. Patients from the lowest socioeconomic quintile were half as likely to have chemotherapy as those from highest quintile (odds ratio = 0.5, 95{\%} CI: 0.4, 0.7). Unmarried patients were significantly less likely to receive treatment (odds ratio = 0.6, 95{\%} CI: 0.5, 0.7). Not receiving chemotherapy was associated with greater mortality from bladder cancer (subdistribution hazard ratio = 1.4, 95{\%} CI: 1.3, 1.5) and from all causes (hazard ratio = 2.0, 95{\%} CI: 1.8, 2.1). Conclusions: We found clear disparities in chemotherapy treatment and survival with respect to socioeconomic and marital status. Future studies should explore the possible reasons why patients with low socioeconomic status and who are unmarried are less likely to have chemotherapy.",
keywords = "Cancer, Chemotherapy, Drug therapy, Epidemiology, Neoplasm metastasis, Urinary bladder neoplasms",
author = "Amy Klapheke and Stanley Yap and Kevin Pan and Cress, {Rosemary D}",
year = "2018",
month = "6",
day = "1",
doi = "10.1016/j.urolonc.2018.03.008",
language = "English (US)",
volume = "36",
pages = "308.e19--308.e25",
journal = "Urologic Oncology",
issn = "1078-1439",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Sociodemographic disparities in chemotherapy treatment and impact on survival among patients with metastatic bladder cancer

AU - Klapheke, Amy

AU - Yap, Stanley

AU - Pan, Kevin

AU - Cress, Rosemary D

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Objective: To evaluate how socioeconomic status and other demographic factors are associated with the receipt of chemotherapy and subsequent survival in patients diagnosed with metastatic bladder cancer. Methods: Using data from the California Cancer Registry, we identified 3,667 patients diagnosed with metastatic urothelial carcinoma of the urinary bladder between 1988 and 2014. The characteristics of patients who did and did not receive chemotherapy as part of the first course of treatment were compared using chi-square tests. Logistic regression was used to identify predictors of chemotherapy treatment. Fine and Gray competing-risks regression and Cox proportional hazards regression were used to estimate bladder cancer-specific and all-cause mortality, respectively. Results: Less than half (46.3%) of patients received chemotherapy. Patients from the lowest socioeconomic quintile were half as likely to have chemotherapy as those from highest quintile (odds ratio = 0.5, 95% CI: 0.4, 0.7). Unmarried patients were significantly less likely to receive treatment (odds ratio = 0.6, 95% CI: 0.5, 0.7). Not receiving chemotherapy was associated with greater mortality from bladder cancer (subdistribution hazard ratio = 1.4, 95% CI: 1.3, 1.5) and from all causes (hazard ratio = 2.0, 95% CI: 1.8, 2.1). Conclusions: We found clear disparities in chemotherapy treatment and survival with respect to socioeconomic and marital status. Future studies should explore the possible reasons why patients with low socioeconomic status and who are unmarried are less likely to have chemotherapy.

AB - Objective: To evaluate how socioeconomic status and other demographic factors are associated with the receipt of chemotherapy and subsequent survival in patients diagnosed with metastatic bladder cancer. Methods: Using data from the California Cancer Registry, we identified 3,667 patients diagnosed with metastatic urothelial carcinoma of the urinary bladder between 1988 and 2014. The characteristics of patients who did and did not receive chemotherapy as part of the first course of treatment were compared using chi-square tests. Logistic regression was used to identify predictors of chemotherapy treatment. Fine and Gray competing-risks regression and Cox proportional hazards regression were used to estimate bladder cancer-specific and all-cause mortality, respectively. Results: Less than half (46.3%) of patients received chemotherapy. Patients from the lowest socioeconomic quintile were half as likely to have chemotherapy as those from highest quintile (odds ratio = 0.5, 95% CI: 0.4, 0.7). Unmarried patients were significantly less likely to receive treatment (odds ratio = 0.6, 95% CI: 0.5, 0.7). Not receiving chemotherapy was associated with greater mortality from bladder cancer (subdistribution hazard ratio = 1.4, 95% CI: 1.3, 1.5) and from all causes (hazard ratio = 2.0, 95% CI: 1.8, 2.1). Conclusions: We found clear disparities in chemotherapy treatment and survival with respect to socioeconomic and marital status. Future studies should explore the possible reasons why patients with low socioeconomic status and who are unmarried are less likely to have chemotherapy.

KW - Cancer

KW - Chemotherapy

KW - Drug therapy

KW - Epidemiology

KW - Neoplasm metastasis

KW - Urinary bladder neoplasms

UR - http://www.scopus.com/inward/record.url?scp=85047319429&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047319429&partnerID=8YFLogxK

U2 - 10.1016/j.urolonc.2018.03.008

DO - 10.1016/j.urolonc.2018.03.008

M3 - Article

C2 - 29628318

AN - SCOPUS:85047319429

VL - 36

SP - 308.e19-308.e25

JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

IS - 6

ER -