title: Determinants of Survival for Adolescents and Young Adults with Urothelial Bladder Cancer: Results from the California Cancer Registry.
abstract: 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 identified whether factors influencing cause specific survival in adolescents and young adults (ages 15 to 39) differed from older adults, and defined prognostic factors specifically in adolescents and young adults using the California Cancer Registry.
  
  
  
  Patients diagnosed with bladder cancer between 1988 through 2012 were included in the study. 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 patients with bladder cancer we identified 1,688 adolescent and young adult patients (1.6%). Compared to older patients these patients had a 58% reduced risk of bladder cancer death (HR 0.42, p <0.001). Significant age interactions were identified involving race/ethnicity and histology. Among adolescents and young adults, nonHispanic African-American patients with low socioeconomic status had poor cause specific (HR 7.1, p <0.001) and overall (HR 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.
authors.affiliation: Davis Senior High School, Davis, California.
authors.forename: Joshua
authors.initials: J
authors.lastname: Lara
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: Ann
authors.initials: A
authors.lastname: Brunson
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: Theresa H M
authors.initials: TH
authors.lastname: Keegan
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: Marcio
authors.initials: M
authors.lastname: Malogolowkin
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: Chong-Xian
authors.initials: CX
authors.lastname: Pan
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: Stanley
authors.initials: S
authors.lastname: Yap
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California. Electronic address: rwdeverewhite@ucdavis.edu.
authors.forename: Ralph
authors.initials: R
authors.lastname: deVere White
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002140:California; D002295:Carcinoma, Transitional Cell / Q000401:mortality*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D012042:Registries; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality*; D055815:Young Adult
keywords: adolescent; epidemiology; health status disparities; urinary bladder neoplasms; young adult