Trends in bladder cancer mortality: The influence of tobacco use and sociodemographic factors in the United States over two decades.

e16621 Background: Despite significant advancements in bladder cancer treatment, mortality rates remain high due to the disease's complexity. The effects of smoking and sociodemographic determinants on mortality from bladder cancer have not been well explored. Methods: We examined trends in bladder cancer mortality related to tobacco use from 1999 to 2023 using data from the CDC WONDER database. Deaths were grouped by age, race/ethnicity, gender, and rural/urban residency. Age-adjusted mortality rates were calculated. Joinpoint regression was used to evaluate annual and average percentage changes (APC, AAPC). Results: A total of 49,511 deaths related to Bladder cancer and tobacco use were identified (10,076 < 65y and 39,435 ≥65y) between 1999 and 2023. The AAMR increased from 0.08 in 1999 to 1.21 in 2016 and then decreased to 1.10 in 2023 (AAPC 13.2, CI (11.8-16.1), p = 0.001). For patients < 65y, the AAMR increased from 0.01 in 1999 to 0.25 in 2019 and then slightly decreased to 0.22 in 2023 (AAPC 13.15, CI (11.34-16.17) p = 0.001). For patients ≥65y, AAMR increased from 0.42 in 1999 to 5.82 in 2016 and then slightly decreased to 5.24 in 2023 (AAPC 13.06, CI (11.79-15.68) p < 0.001). For male patients, AAMR increased from 0.13 in 1999 to 2.13 in 2016 and then slightly decreased to 1.88 in 2023 (AAPC 13.20, CI (11.95-16.04) p < 0.001). For female patients, the AAMR increased from 0.03 in 1999 to 0.46 in 2019 and then slightly decreased to 0.43 (AAPC 10.80 CI (9.39-14.94) p < 0.001). For Hispanics AAMR increased from 0.16 in 2004 to 0.36 in 2016 and then decreased to 0.32 in 2023 (AAPC 2.33 CI (0.73-4.55) p < 0.006, Non-Hispanics' AAMR increased from 0.08 in 1999 to 1.32 in 2015 and then decreased to 1.18 in 2023 (AAPC 13.24, CI (11.92-15.79) p < 0.001. Regarding race, non-Hispanic whites (NHWs), the AAMR increased from 0.08 in 1999 to 1.45 in 2015 and then decreased to 1.33 in 2023 (AAPC 13.73, CI (12.41-16.62) p < 0.001), non-Hispanic blacks (NHBs), the AAMR increased from 0.17 in 2003 to 0.72 in 2023 (AAPC 8.01, CI (4.95-13.79) p < 0.001). From 1999 to 2020, as per the 2013 NCHS Urban-Rural Scheme for Counties, AAMR for residents of urban counties increased from 0.07 in 1999 to 1.05 in 2020 (AAPC 15.67 (14.03-19.69), p < 0.001). For residents of rural areas, the AAMR increased from 0.12 in 1999 to 1.79 in 2015 and then decreased to 1.58 in 2020 (AAPC 13.04, CI (11.67-16.27) p = 0.001). Conclusions: This study illustrates a steadily increasing trend in AAMR for tobacco-related bladder cancer from 1999 to 2023, even though there has been a moderate decrease in most of the population groups in recent years. The highest increases were noted among individuals aged 65 years and older, men, and non-Hispanic whites. Even though there was still an increase in mortality rates among Hispanic populations, there was a recent decrease in AAMR. Rural dwellers had a higher mortality rate than urban, though the gap decreased in recent years.