Sex and the Diagnostic Pathway to Bladder Cancer among Veterans: No Evidence of Disparity.
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Cystoscopy
/ methods
Delayed Diagnosis
/ statistics & numerical data
Female
Hematuria
/ diagnosis
Humans
Male
Middle Aged
Retrospective Studies
Sex Distribution
Time Factors
Time-to-Treatment
United States
/ epidemiology
United States Department of Veterans Affairs
Urinary Bladder Neoplasms
/ complications
Veterans
/ statistics & numerical data
Journal
Women's health issues : official publication of the Jacobs Institute of Women's Health
ISSN: 1878-4321
Titre abrégé: Womens Health Issues
Pays: United States
ID NLM: 9101000
Informations de publication
Date de publication:
Historique:
received:
21
06
2019
revised:
04
10
2019
accepted:
08
11
2019
pubmed:
25
12
2019
medline:
18
8
2020
entrez:
25
12
2019
Statut:
ppublish
Résumé
Longer time intervals from presentation with hematuria to bladder cancer diagnosis have been reported among women compared with men. Despite women being the fastest growing cohort within the Department of Veterans Affairs, little is known about women veterans with bladder cancer. Our objectives were to quantify the time from hematuria to bladder cancer diagnosis in Department of Veterans Affairs and assess differences between sexes. This was a retrospective cohort study of patients diagnosed with bladder cancer from 2001 to 2016. Included were patients with hematuria for fewer than 365 days before a bladder cancer diagnosis and who had a record of diagnostic cystoscopy after hematuria but before diagnosis. We evaluated the number of days from hematuria to diagnostic cystoscopy (clinical appraisal), cystoscopy to bladder cancer diagnosis (surgical appraisal), and hematuria to bladder cancer diagnosis (total diagnostic appraisal). We used quantile regression models to separately evaluate the effect of sex on the three appraisal intervals. Data from 213 women and 24,295 men were analyzed. The median clinical appraisal time was 78 days for women and 72 for men (p = .49). The median surgical appraisal time was 32 days for women and 33 for men (p = .74). The median total diagnostic appraisal time was 135 days for women and 130 for men (p = .71). Multivariable analyses showed no differences between men and women for any of the three appraisal intervals. The majority of time from hematuria to bladder cancer diagnosis is spent in clinical appraisal, but little difference was observed between men and women in Department of Veterans Affairs.
Sections du résumé
BACKGROUND
Longer time intervals from presentation with hematuria to bladder cancer diagnosis have been reported among women compared with men. Despite women being the fastest growing cohort within the Department of Veterans Affairs, little is known about women veterans with bladder cancer. Our objectives were to quantify the time from hematuria to bladder cancer diagnosis in Department of Veterans Affairs and assess differences between sexes.
METHODS
This was a retrospective cohort study of patients diagnosed with bladder cancer from 2001 to 2016. Included were patients with hematuria for fewer than 365 days before a bladder cancer diagnosis and who had a record of diagnostic cystoscopy after hematuria but before diagnosis. We evaluated the number of days from hematuria to diagnostic cystoscopy (clinical appraisal), cystoscopy to bladder cancer diagnosis (surgical appraisal), and hematuria to bladder cancer diagnosis (total diagnostic appraisal). We used quantile regression models to separately evaluate the effect of sex on the three appraisal intervals.
RESULTS
Data from 213 women and 24,295 men were analyzed. The median clinical appraisal time was 78 days for women and 72 for men (p = .49). The median surgical appraisal time was 32 days for women and 33 for men (p = .74). The median total diagnostic appraisal time was 135 days for women and 130 for men (p = .71). Multivariable analyses showed no differences between men and women for any of the three appraisal intervals.
CONCLUSIONS
The majority of time from hematuria to bladder cancer diagnosis is spent in clinical appraisal, but little difference was observed between men and women in Department of Veterans Affairs.
Identifiants
pubmed: 31870696
pii: S1049-3867(19)30497-9
doi: 10.1016/j.whi.2019.11.001
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
128-135Informations de copyright
Published by Elsevier Inc.