Frontiers in oncology · 2026
Evolving patterns of bladder cancer mortality in US adults: a two-decade analysis reveals persistent disparities despite overall progress (1999-2020).
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Sun Lingfeng, Liu Chengyi, Yuan Lin
Аннотация
OBJECTIVE: Bladder cancer represents one of the most common malignancies in the United States, with mortality trends reflecting disease burden and clinical management effectiveness. This study aimed to comprehensively analyze long-term trends and demographic disparities in bladder cancer mortality among US adults from 1999 to 2020 using national data.
METHODS: Mortality data with bladder cancer (ICD-10 code: C67) as the underlying cause of death were extracted from the CDC WONDER database for 1999-2020.AAMR was calculated. Joinpoint regression models were employed to calculate APC and AAPC to identify temporal trends and inflection points in mortality rates. Stratified analyses were conducted by sex, age group, race/ethnicity, urbanization level, and geographic region.
RESULTS: From 1999 to 2020, a total of 319,229 adult deaths in the United States had bladder cancer as the underlying cause of death. Overall age-adjusted mortality rates declined from 6.737 per 100,000 in 1999 to 6.159 per 100,000 in 2020 (AAPC: -0.410, 95% CI: -0.495 to -0.310, P < 0.001). Joinpoint regression analysis revealed a significant decline trend after 2016 (APC changed from -0.347 to -2.118). Stratified analysis showed that male mortality rates were significantly higher than female rates. White populations had the highest recorded mortality rate (7.003 per 100,000), though this likely reflects diagnostic coding biases rather than true biological differences. Regional disparities existed, with the Northeast showing the highest mortality rates. Non-metropolitan residents had higher mortality rates (6.887 per 100,000) compared to metropolitan residents (6.64 per 100,000).
CONCLUSION: Over the past two decades, bladder cancer mortality among US adults has demonstrated an overall declining trend, reflecting advances in diagnostic and therapeutic technologies. However, significant disparities by sex, race, and geographic region persist, indicating prominent health inequality issues. Future efforts should focus on strengthening early screening, smoking cessation interventions, and standardized treatment for high-risk populations to further reduce disease burden.
METHODS: Mortality data with bladder cancer (ICD-10 code: C67) as the underlying cause of death were extracted from the CDC WONDER database for 1999-2020.AAMR was calculated. Joinpoint regression models were employed to calculate APC and AAPC to identify temporal trends and inflection points in mortality rates. Stratified analyses were conducted by sex, age group, race/ethnicity, urbanization level, and geographic region.
RESULTS: From 1999 to 2020, a total of 319,229 adult deaths in the United States had bladder cancer as the underlying cause of death. Overall age-adjusted mortality rates declined from 6.737 per 100,000 in 1999 to 6.159 per 100,000 in 2020 (AAPC: -0.410, 95% CI: -0.495 to -0.310, P < 0.001). Joinpoint regression analysis revealed a significant decline trend after 2016 (APC changed from -0.347 to -2.118). Stratified analysis showed that male mortality rates were significantly higher than female rates. White populations had the highest recorded mortality rate (7.003 per 100,000), though this likely reflects diagnostic coding biases rather than true biological differences. Regional disparities existed, with the Northeast showing the highest mortality rates. Non-metropolitan residents had higher mortality rates (6.887 per 100,000) compared to metropolitan residents (6.64 per 100,000).
CONCLUSION: Over the past two decades, bladder cancer mortality among US adults has demonstrated an overall declining trend, reflecting advances in diagnostic and therapeutic technologies. However, significant disparities by sex, race, and geographic region persist, indicating prominent health inequality issues. Future efforts should focus on strengthening early screening, smoking cessation interventions, and standardized treatment for high-risk populations to further reduce disease burden.