Achieving Health Equity in Bladder Cancer Care

Every May, the oncology community recognizes Bladder Cancer Awareness Month. Bladder cancer is the 6^th most common cancer diagnosed among Americans and, according to estimates, the United States will see about 81 thousand new cases and 17 thousand deaths due to bladder cancer in 2022. Though risk of this disease is most prevalent in White men (age 55 and over), bladder cancer impacts women and underserved populations worldwide. In recognition of Bladder Cancer Awareness Month, ACCC would like to stress the importance of reducing existing disparities in bladder cancer care.

Health disparities in evaluation, management, and mortality persist in populations where bladder cancer is less common. And these disparities are expected to worsen as a result of the COVID-19 pandemic—fewer people presented for symptoms of bladder cancer and to receive routine care. Further, as oncology care is increasingly provided in the community setting, healthcare providers are seeing people from wider geographic areas, exacerbating disparities in access to healthcare.

Some factors that contribute to health disparities in bladder cancer include:

• Type of hospital providing the care

• Provider density

• Travel burden, especially when receiving care in a center of excellence or academic center

• Being female, Black, Hispanic, or of low socio-economic status or a lower education level (e.g., high school degree) with the disease.

These factors are associated with a decreased likelihood of receiving critical treatment, regardless of insurance type. And racial disparities are further increased by access to care burdens.

Mitigating Disparities

ACCC’s Multidisciplinary Bladder Cancer Care education program analyzed Medicare claims data between 2016 to 2019 to contextualize the health disparities underserved populations experience before, during, and after diagnosis. In its publication—“Understanding and Mitigating Disparities in Bladder Cancer Care”—ACCC offers 10 tips to help improve outcomes and elevate health equity in cancer care delivery. These tips include promptly referring patients with hematuria to urology for timely full urologic evaluation and practicing culturally competent health literacy communication and shared decision-making to keep patients engaged in their care.

State by State

The Bladder Cancer Advocacy Network has also launched a new website: Bladder Cancer by State. Users can quickly view their state’s bladder cancer cases “at a glance” and find direct links to their state’s Department of Health, National Cancer Institute-designated and National Comprehensive Cancer Network member institutions, Veterans Administration hospitals, and information on clinical trials.

Through these resources, oncology professionals can better address the existing barriers to quality bladder cancer care for underserved populations and improve care coordination for better health outcomes.

More Resources From ACCC

• Multidisciplinary Bladder Cancer Care

• Urothelial Carcinoma in the Community

• Get the Facts About Bladder Cancer

• Let’s Be Clear: Communicating to Improve the Cancer Patient Experience

• Health Literacy: From Assessment to Action

• Health Equity at ACCC