Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis

Abstract Background Understanding sex‐specific factors contributing to advanced‐stage diagnosis can guide interventions to reduce sex inequality in patients with urological cancers. Method We used linked primary care and cancer registry data to examine associations between symptoms and advanced‐stag...

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Main Authors: Yin Zhou, Georgios Lyratzopoulos, Prabhakar Rajan, Fiona M. Walter, Jianhua Wu
Format: Article
Language:English
Published: Wiley 2024-07-01
Series:BJUI Compass
Subjects:
Online Access:https://doi.org/10.1002/bco2.360
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author Yin Zhou
Georgios Lyratzopoulos
Prabhakar Rajan
Fiona M. Walter
Jianhua Wu
author_facet Yin Zhou
Georgios Lyratzopoulos
Prabhakar Rajan
Fiona M. Walter
Jianhua Wu
author_sort Yin Zhou
collection DOAJ
description Abstract Background Understanding sex‐specific factors contributing to advanced‐stage diagnosis can guide interventions to reduce sex inequality in patients with urological cancers. Method We used linked primary care and cancer registry data to examine associations between symptoms and advanced‐stage in 1151 bladder cancer and 440 renal cancer patients diagnosed between January 2012 and December 2015 in England. We performed logistic regression, adjusting for sex, age, deprivation and routes to diagnosis, including interaction terms between symptoms and sex and symptoms and age. Results Female sex (OR vs. men 1.89 [1.28–2.79]; p = 0.001) and patients presenting with urinary tract infections (OR 2.22 [1.34–3.69]) and abdominal symptoms (OR 2.19 [1.30–3.70]) were associated with increased odds of advanced‐stage bladder cancer (vs. haematuria, p = 0.016 for both). Women with haematuria and men with abdominal symptoms (compared with the opposite sex with the same presenting symptom) were more likely to have advanced‐stage bladder cancer. Neither sex nor symptom associations were observed for renal cancer. Conclusion Non‐haematuria symptoms are associated with higher risk of advanced‐stage bladder cancer. Greater risk of advanced‐stage bladder cancer in women may reflect biological differences in haematuria onset and sex differences during diagnostic process. Identifying higher risk women with haematuria may reduce sex inequalities in bladder cancer outcomes.
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spelling doaj-art-b5aa4e3144ce4992999f804828f367e42025-08-20T01:59:56ZengWileyBJUI Compass2688-45262024-07-015780581210.1002/bco2.360Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosisYin Zhou0Georgios Lyratzopoulos1Prabhakar Rajan2Fiona M. Walter3Jianhua Wu4Wolfson Institute of Population Health Queen Mary University of London London UKInstitute of Epidemiology and Health Care University College London London UKBarts Cancer Institute, Cancer Research UK City of London Centre Queen Mary University of London London UKWolfson Institute of Population Health Queen Mary University of London London UKWolfson Institute of Population Health Queen Mary University of London London UKAbstract Background Understanding sex‐specific factors contributing to advanced‐stage diagnosis can guide interventions to reduce sex inequality in patients with urological cancers. Method We used linked primary care and cancer registry data to examine associations between symptoms and advanced‐stage in 1151 bladder cancer and 440 renal cancer patients diagnosed between January 2012 and December 2015 in England. We performed logistic regression, adjusting for sex, age, deprivation and routes to diagnosis, including interaction terms between symptoms and sex and symptoms and age. Results Female sex (OR vs. men 1.89 [1.28–2.79]; p = 0.001) and patients presenting with urinary tract infections (OR 2.22 [1.34–3.69]) and abdominal symptoms (OR 2.19 [1.30–3.70]) were associated with increased odds of advanced‐stage bladder cancer (vs. haematuria, p = 0.016 for both). Women with haematuria and men with abdominal symptoms (compared with the opposite sex with the same presenting symptom) were more likely to have advanced‐stage bladder cancer. Neither sex nor symptom associations were observed for renal cancer. Conclusion Non‐haematuria symptoms are associated with higher risk of advanced‐stage bladder cancer. Greater risk of advanced‐stage bladder cancer in women may reflect biological differences in haematuria onset and sex differences during diagnostic process. Identifying higher risk women with haematuria may reduce sex inequalities in bladder cancer outcomes.https://doi.org/10.1002/bco2.360bladder cancercancer stageearly diagnosisrenal cancersex inequalitysymptomatic presentation
spellingShingle Yin Zhou
Georgios Lyratzopoulos
Prabhakar Rajan
Fiona M. Walter
Jianhua Wu
Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis
BJUI Compass
bladder cancer
cancer stage
early diagnosis
renal cancer
sex inequality
symptomatic presentation
title Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis
title_full Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis
title_fullStr Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis
title_full_unstemmed Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis
title_short Understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis
title_sort understanding symptom contribution to sex inequality in bladder and renal cancer stage at diagnosis
topic bladder cancer
cancer stage
early diagnosis
renal cancer
sex inequality
symptomatic presentation
url https://doi.org/10.1002/bco2.360
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