Abstract 3621: Geographic and racial disparities in bladder cancer care in the U.S.

Abstract Introduction: This study aims to elucidate variations in bladder cancer health outcomes and social determinants of health across diverse geographic regions in the US. It specifically investigates racial disparities in care delays among patients with bladder cancer, identifying critical intervention areas to enhance health equity. Methods: A retrospective database analysis was conducted utilizing Medicare fee-for-service data for patients with bladder cancer diagnosed between January 1, 2021, and December 31, 2022, to measure and compare rates of diagnosis, interventions (surgical or pharmacological), specialist visit, time-to-specialist visit, and diagnosis-to-treatment initiation across US racial and ethnic groups. The reference group for rates was White patients. For example, the diagnosis rate ratio for Black patients was the quotient of diagnosis rates among Black residents and diagnosis rates among White residents diagnosed with bladder cancer during the study period. Diagnosis claims with ICD-10 code C67 and ICD-9 code 188 were used. Medicare patients with at least one year of enrollment were included. Patients were excluded if their first bladder cancer diagnosis was outside the study period. Results: Diagnosis rate ratios were 0.5 for Black patients and 0.4 for Hispanic patients. Intervention rate ratios were 0.9 for Black patients and 0.8 for Hispanic patients. Specialist visit rate ratios were 0.9 for both Black patients and Hispanic patients. Median time-to-specialist visit was 21 days for all patients, while mean (standard deviation) times were 89 (162) days for Black patients, 77 (128) days for Hispanic patients, and 85 (148) days for White patients. Mean (standard deviation) diagnosis-to-treatment initiation were 29 (91) days for Black patients, 33 (94) days for Hispanic patients, and 27 (90) days for White patients; the corresponding 95% confidence interval was (29, 36) and (26, 28) for Hispanic and White patients, respectively. Conclusion: At the national level, diagnosis-to-treatment initiation for bladder cancer was significantly delayed for Hispanic patients and disparities in intervention were identified for Black and Hispanic patients in hotspots of economic inequity. Stakeholders, including population health decision makers, healthcare providers, payers, advocacy groups and policymakers, can use the study findings to design and implement strategies to reduce geographic and racial disparities, foster collaboration among key stakeholders, and improve overall healthcare quality. Citation Format: Atreyee Majumder, Daniel Erim, Arveen Kaur, Lisa Dwyer Orr. Geographic and racial disparities in bladder cancer care in the U.S. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3621.