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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| Format: | Article |
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Wiley
2024-07-01
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| Series: | BJUI Compass |
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| 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. |
| format | Article |
| id | doaj-art-b5aa4e3144ce4992999f804828f367e4 |
| institution | OA Journals |
| issn | 2688-4526 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | BJUI Compass |
| 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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