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NORTH WESTERN CANCER REGISTRY BLADDER CANCER: Later stage and worse survival in women from deprived areas British Journal of Cancer (2004) 90, 2142-2144.

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Presentation on theme: "NORTH WESTERN CANCER REGISTRY BLADDER CANCER: Later stage and worse survival in women from deprived areas British Journal of Cancer (2004) 90, 2142-2144."— Presentation transcript:

1 NORTH WESTERN CANCER REGISTRY BLADDER CANCER: Later stage and worse survival in women from deprived areas British Journal of Cancer (2004) 90, North Western Cancer Registry T.Moran A-M Sowerbutts Stuart Collins R Hartley D.Chandler Christie Hospital NHS Trust N.Clarke R.Cowan Introduction

2 Bladder is the only common cancer for which women have a worse survival than men Largest gap at one year Some evidence that women are more likely to present with later stage disease Background NORTH WESTERN CANCER REGISTRY Aim of study: To determine why women have a worse prognosis than men: a) Do women present later? b) Is social deprivation a factor?

3 Resident of Greater Manchester, Lancashire and South Cumbria Muscle-invasive tumour diagnosed in 1998 (MID) No history of bladder cancer Criteria for study subjects NORTH WESTERN CANCER REGISTRY

4 1190 Patients with bladder tumours identified from North Western Cancer Registry database Pathology reports reviewed to identify those with histologically verified muscle-invasive disease Case notes requested on: (i) Those with histologically verified MID (ii) Those who underwent cystectomy or radiotherapy (iii) Those who died within 3 years of diagnosis 90% reviewed Methods I NORTH WESTERN CANCER REGISTRY

5 Deaths classified into those due to bladder cancer and to other causes Stage classified into advanced (T4b and/or M1) and non-advanced Deprivation measured using the Townsend Score Methods II NORTH WESTERN CANCER REGISTRY

6 Statistics Frequency distribution  2 and t-tests Survival Kaplan-Meier Log-Rank test NORTH WESTERN CANCER REGISTRY

7 Characteristics of Study Population (347) Median Age Male 227 (65.5%) 72.5 Female 120 (34.5%) 75.5 NORTH WESTERN CANCER REGISTRY

8 Difference in cause-specific survival by sex Time Difference (Months) % %* % % 49 women and 48 men died from bladder cancer in the first six months * Log-Rank  2 = 14.7; 1 df; p<0.01 NORTH WESTERN CANCER REGISTRY

9 Advanced stage at diagnosis Male33(14.5%) Female35 (29.2%) (  2 = 10.7; 1 df; p<0.01) NORTH WESTERN CANCER REGISTRY

10 Number (%) with advanced disease by deprivation quintiles Quintile Male Female 1 8 (17.8%) 3 (15.8%) 2 5 (11.9%) 0 ( 0.0%) 3 4 (12.1%) 9 (31.0%) 4 7 (11.9%) 9 (36.0%) 5 9 (18.8%)14 (43.8%) Total33 (14.5%)35 (29.2%) NORTH WESTERN CANCER REGISTRY

11 Six-month survival rates by deprivation quintiles NORTH WESTERN CANCER REGISTRY Survival Rate (%) More deprived Quintile

12 Survival and stage by two deprivation categories for females Number (%) with Six-Month Survival Advanced Disease Quintiles 3 (8.8%) 73.5% 1+2 Quintiles 32 (37.5%) 52.3% (  2 = 9.5; 1 df; p<0.01) (  2 = 4.8; 1 df; p<0.05) NORTH WESTERN CANCER REGISTRY More deprived Worse

13 Women from more deprived backgrounds present with later stage disease and have a worse prognosis than either men or women from less deprived neighbourhoods. Conclusion NORTH WESTERN CANCER REGISTRY

14 BLADDER CANCER: Later stage and worse survival in women from deprived areas British Journal of Cancer (2004) 90, North Western Cancer Registry T.Moran A-M Sowerbutts Stuart Collins R Hartley D.Chandler Christie Hospital NHS Trust N.Clarke R.Cowan


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