Abstract: Black patients and women are more likely than White men to be diagnosed with bladder cancer at an advanced stage. We developed a natural history model of bladder cancer to evaluate how differences in stage-specific diagnosis rates by race and sex contribute to disparities in stage at diagnosis and to estimate the potential impact of improving diagnosis. Compared with White males, estimated diagnosis hazard ratios were 0.95 (95% uncertainty interval [UI], 0.92-0.96) for White females, 0.84 (95% UI, 0.82-0.86) for Black males, and 0.59 (95% UI, 0.58-0.62) for Black females. Equalizing diagnosis rates shifted diagnosis toward earlier stages and increased life expectancy at age 70, conditional on diagnosis, by 0.12 years (95% UI, 0.08-0.19) for White females, 0.31 years (95% UI, 0.27-0.35) for Black males, and 1.3 years (95% UI, 1.2-1.4) for Black females. These findings suggest that disparities in diagnosis contribute to racial and sex differences in bladder cancer outcomes and that improving diagnosis could substantially increase survival, particularly among Black women.

Bio:  Praveen Kumar is an Assistant Professor in the Department of Health Policy and Management at the University of Pittsburgh School of Public Health. His research focuses on simulation modeling, decision analysis, and cost-effectiveness analysis to evaluate public health interventions. His current work spans opioid use disorder, healthcare-associated infections, exercise oncology, and bladder cancer. He welcomes opportunities for collaboration and interdisciplinary research applying decision science methods to address important public health challenges.