Determinants of survival in adolescents and young adults with urothelial bladder cancer: results from the California Cancer Registry

Bladder cancer is a common malignancy often diagnosed in older adults. Previous studies have reported racial/ethnic disparities in bladder cancer survival outcomes, but have not focused on younger patients. We sought to identify whether factors influencing cause-specific survival in adolescents and young adults (ages 15-39) differed from older adults, and to define prognostic factors specifically in adolescents and young adults using the California Cancer Registry.

Patients diagnosed with bladder cancer between 1988 through 2012 were included. The primary outcome measure was cause specific survival. A multivariable Cox proportional hazards regression model was used to evaluate predictors of cause-specific survival in patients of all ages and in adolescents/young adults. Interactions of age and other variables between younger and older adult patients were assessed.

Of 104,974 bladder cancer patients, we identified 1,688 adolescent and young adult patients (1.6%). When compared to older patients, these patients had a 58% reduced risk of bladder cancer death (Hazard Ratio 0.42; p<0.001). Significant age interactions were identified involving race/ethnicity and histology. Among AYAs, non-Hispanic African Americans with low socioeconomic status had poor cause- specific (Hazard Ratio 7.1, p<0.001) and overall (Hazard Ratio 5.02, p<0.001) survival.

Racial/ethnic and socioeconomic disparities exist in adolescent and young adult patients with bladder cancer in California. Further studies are warranted to identify the underlying causes in order to overcome these disparities.

The Journal of urology. 2016 May 18 [Epub ahead of print]

Joshua Lara, Ann Brunson, Theresa H M Keegan, Marcio Malogolowkin, Chong-Xian Pan, Stanley Yap, Ralph deVere White

Davis Senior High School, Davis CA., University of California Davis Comprehensive Cancer Center, Sacramento, CA., University of California Davis Comprehensive Cancer Center, Sacramento, CA., University of California Davis Comprehensive Cancer Center, Sacramento, CA., University of California Davis Comprehensive Cancer Center, Sacramento, CA., University of California Davis Comprehensive Cancer Center, Sacramento, CA., University of California Davis Comprehensive Cancer Center, Sacramento, CA. Electronic address: .

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