title: Ethnic differences in bladder cancer survival.
abstract: OBJECTIVE
  To examine trends in bladder cancer survival among whites, blacks, Hispanics, and Asian/Pacific Islanders in the United States over a 30-year period. Racial disparities in bladder cancer outcomes have been documented with poorer survival observed among blacks. Bladder cancer outcomes in other ethnic minority groups are less well described.
  
  
  METHODS
  From the Surveillance, Epidemiology and End Results cancer registry data, we identified patients diagnosed with transitional cell carcinoma of the bladder between 1975 and 2005. This cohort included 163,973 white, 7731 black, 7364 Hispanic, and 5934 Asian/Pacific Islander patients. We assessed the relationship between ethnicity and patient characteristics. Disease-specific 5-year survival was estimated for each ethnic group and for subgroups of stage and grade.
  
  
  RESULTS
  Blacks presented with higher-stage disease than whites, Hispanics, and Asian/Pacific Islanders, although a trend toward earlier-stage presentation was observed in all groups over time. Five-year disease-specific survival was consistently worse for blacks than for other ethnic groups, even when stratified by stage and grade. Five-year disease-specific survival was 82.8% in whites compared with 70.2% in blacks, 80.7% in Hispanics, and 81.9% in Asian/Pacific Islanders. There was a persistent disease-specific survival disadvantage in black patients over time that was not seen in the other ethnic groups.
  
  
  CONCLUSIONS
  Ethnic disparities in bladder cancer survival persist between whites and blacks, whereas survival in other ethnic minority groups appears similar to that of whites. Further study of access to care, quality of care, and treatment decision making among black patients is needed to better understand these disparities.
authors.affiliation: Department of Surgery, University of Utah, Salt Lake City, Utah, USA. yeed1@sutterhealth.org
authors.forename: David S
authors.initials: DS
authors.lastname: Yee
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Ishill
authors.forename: William T
authors.initials: WT
authors.lastname: Lowrance
authors.forename: Harry W
authors.initials: HW
authors.lastname: Herr
authors.forename: Elena B
authors.initials: EB
authors.lastname: Elkin
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D002295:Carcinoma, Transitional Cell / Q000208:ethnology* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000208:ethnology* / Q000401:mortality; D044465:White People / Q000706:statistics & numerical data