Unmasking disparities in bladder cancer outcomes in the disaggregated Asian American population

Research on urothelial carcinoma of the bladder (UCUB) in non-Hispanic Asian American (NHAA) populations typically amalgamate all subgroups, masking significant intra-ethnic difference. This study aimed to examine variations in UCUB characteristics and outcomes within NHAA populations.

Patients with UCUB were identified from the Surveillance, Epidemiology, and End Results database. The NHAA cohort disaggregated into Chinese, Filipino, South Asian, Japanese, Korean, Vietnamese, and other Asian subgroups. Kaplan-Meier and Cox proportional hazards models were used to estimate unadjusted and adjusted overall survival (OS) and cancer-specific survival (CSS).

NHAA patients (n = 2,686) exhibited the longest median OS (88 months) compared to other cohorts (p < 0.001). Among NHAA subgroups, five-year OS rates ranged from 50% in Filipino patients to 64% in other Asian groups. In adjusted analyses, Chinese (HR 0.84, 95% CI 0.74-0.94), Korean (HR 0.74, 95% CI 0.61-0.91), and other Asian (HR 0.68, 95% CI 0.56-0.82) patients exhibited significantly reduced mortality risk relative to Non-Hispanic White patients.

Filipino Americans faced comparatively poorer survival, while Chinese and Korean Americans showed more favorable prognoses. These findings highlight the need for targeted, culturally tailored interventions and refined risk stratification to enhance equity in the management of UCUB.