Temporal trends in mortality from bladder cancer with chronic kidney disease in the United States, 1999–2023: A population-based analysis.

Abstract

649 Background: Bladder cancer frequently coexists with chronic kidney disease (CKD), a comorbidity that may affect treatment options and survival. Despite awareness of multimorbidity in oncology, national mortality trends for patients with both bladder cancer and CKD have not been well explored. Objective: To evaluate long-term trends in mortality due to bladder cancer with CKD in U.S. from 1999-2023 across demographic and geographic subgroups. Methods: Mortality data were retrieved from the CDC WONDER database using ICD-10 codes C67 (Neoplasm of bladder) and N-18 (CKD). We analyzed age-adjusted mortality rates (AAMR) per 100,000 population across sex, race, census region and urbanization level and crude rates (CR) across age groups (25-85+). Trends were analyzed through Joinpoint regression to estimate the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) with 95% confidence intervals (CIs). Results: Between 1999 and 2023, 111947 deaths were attributed to bladder cancer with CKD, Overall AAMR (32.1) increased significantly (AAPC = 1.09%, p = 0.006). Males had higher AAMR (43.9) than females (27.3). Mortality rose significantly among both males (AAPC = 0.8%, p=0.02) and females (AAPC=1.2%, p=0.008). Black/African Americans showed highest AAMR (57.8). However, Trends increased significantly among White individuals (AAPC = 1.5%, p < 0.001). Regional variation in AAMRs was evident (Midwest: 34.1, South:33.01, West:30.7, Northeast:29.7). Mortality increased in the Midwest (AAPC=1.57%) and south (AAPC=1.01%).West Virginia had the highest AAMR (43.4) among states. Rural areas had a significant rise (AAPC = 1.70%, p = 0.001), while urban areas remained stable. The highest increase occurred in the 75–84 (AAPC = 0.9%, p = 0.02) and 85+ age group (AAPC = 3.04%, p < 0.001). Conclusions: The findings from this analysis highlight growing mortality disparities among patients with concurrent bladder cancer and CKD, particularly in older white males, and rural populations. Focused nephro-oncology interventions are warranted in high-risk groups.