How Bladder Cancer is Different for People of Color

Cancer development, treatment, and outcomes are tricky topics to understand. The underlying reasons why a person gets cancer or how they might respond to treatment are often unknown and depend on a variety of factors. Just as researchers can study different risk factors and treatments, they can also study different characteristics of people with cancer. Learning more about the people getting cancer and their overall outcomes can help us develop new treatments and better identify those at risk. The goal of understanding these risks is to prevent worsened outcomes for those at risk.

Studying bladder cancer’s relationship with race and ethnicity

Many different characteristics have been studied in relation to cancer in recent years. However, there has been a growing interest in learning more about race and ethnicity differences in relation to cancer. While these kinds of studies have been conducted for many different types of cancers, there isn’t a lot of information available on bladder cancer’s relationship with race and ethnicity. A 2018 study in the journal Scientific Reports investigated these topics and how they relate specifically to bladder cancer. The researchers used a database from the National Cancer Institute with information on thousands of people with bladder cancer in the United States.¹ Overall, they found some significant results when it came to race and ethnicity. Some of these findings are below.

Who is getting bladder cancer?

When looking at the number of new cases of bladder cancer, the researchers found that:¹

• White people had the highest number of new cases of bladder cancer, followed by black people.
• Latinos and Asian and Pacific Islanders had the lowest number of new cases.
• More men received a bladder cancer diagnosis than women. However, the ratio between men and women varied with race. About 75 percent of white people with bladder cancer are males, while men make up only 65 percent of bladder cancer cases in black people.
• White people with bladder cancer had the highest average age of diagnosis, at 70.9 years-old. Latinos with bladder cancer had the earliest age of diagnosis at 66.6 years-old.

Varying diagnoses

The study found that certain races and ethnicities were more likely than others to get different types of bladder cancer or to be diagnosed at different points. Some of the trends found in diagnosis included:¹

• Grade of tumor (aggressiveness of the cancer): Asian and Pacific Islanders had the most cases of grade IV (high-grade) cancer, while white people and Latinos had more grade II tumors. Black people with bladder cancer fell in the middle with more cases of grade III cancers.
• Stage of tumor (how far the cancer has spread): White people were mostly in stage II, while black people with bladder cancer had the most cases of stage III and stage IV cancer.
• Tumor size: Asian and Pacific Islanders with bladder cancer had the smallest overall tumor size at 38.5 mm. while black people with bladder cancer had the largest tumor size at 46.3 mm.
• Lymph nodes involved: Although most people with bladder cancer had no cancer in their lymph nodes at the time of diagnosis, white people had the highest percentage of having negative nodes (almost 93 percent had negative nodes).

Differences in treatment outcomes and survival

Just like for diagnosis, there were some differences found between the different racial and ethnic groups and long-term outcomes.¹

• The median survival time for all people with bladder cancer in the study was 50 months. White people had the longest average overall survival and black people had the shortest (51 months compared to 33 months).
• Across all ages, white people had the highest survival rates, except between the ages of 40-64 years old. In this group, Asian and Pacific Islanders with bladder cancer had the highest rates of survival. Black people with bladder cancer had the lowest survival rate across all ages and types of bladder cancer.
• Surgery and surgery combined with chemotherapy were the most common treatment options used. White people had the highest surgery rates and Asian and Pacific Islanders had the highest rates of surgery combined with chemotherapy.
• Black people with bladder cancer had the highest rate of having no treatment at all, as well as the highest rates of surgery followed by radiation with or without chemotherapy.
• Survival after different types of treatment varied based on race and/or ethnicity, with some groups surviving longer at different stages or after certain treatments than others. These results varied, but black people with bladder cancer tended to have lower post-treatment survival than other groups.

What do these results mean?

Overall, these results suggest that there are differences in cancer development, treatment response, and survival with bladder cancer between racial and ethnic groups. The reasons for this are not well understood, and may be related to a variety of different factors. Some of these may be related to genetics, environmental or work exposures, social factors, financial issues, lifestyle practices, diet, access to healthcare and helpful resources, and more. This is also only one study, and much more research is needed to understand the factors at play. For the time being, studies like this one help call out the vast differences in general, and may help doctors better diagnose and treat patients from all backgrounds.

Resources for minority groups with bladder cancer

This information may seem overwhelming and confusing, especially for individuals belonging to minority groups that appear to have worse health outcomes. It’s okay to ask for help and support as you navigate your journey. While some large organizations have resources designed for everyone living with bladder cancer, there are some minority-specific organizations that can help as well. Several resources to consider if you or a loved one with bladder cancer belongs to a minority group include the following:²

• Black Women’s Health Imperative: Provides health-related support to black women and girls.
• Latinas Contra Cancer: Provides health education and support group services to Spanish-speaking women.
• Malecare: Supports male cancer survivors, including underserved populations, like minority men with cancer.