658 Background: Bladder cancer is the sixth most common malignancy in the United States and remains a significant contributor to cancer-related mortality. Despite diagnostic and therapeutic advances, comprehensive evaluation of long-term mortality trends by demographic and geographic factors remains limited. This study assessed national bladder cancer mortality patterns over a 25-year period. Methods: Age-adjusted mortality rates (AAMRs) for bladder cancer from 1999 to 2024 were obtained from the CDC WONDER database. Rates were calculated per 100,000 population using the U.S. standard population. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CI). Trends were examined by race/ethnicity, sex, age group, U.S. Census region, and urbanization level. Results: Overall bladder cancer mortality demonstrated a modest decline over the study period (AAPC: –0.26%; 95% CI: –0.34 to –0.18; p < 0.001). Mortality decreased among Hispanic (APC: –0.47%; 95% CI: –0.71 to –0.23) and Asian/Pacific Islander populations (APC: –0.57%; 95% CI: –0.86 to –0.28), while American Indian/Alaska Native populations showed a slight increase (APC: +0.19%). Black/African American populations demonstrated declining mortality until 2019 (APC: –0.98%) followed by a plateau. In 2024, Whites had the highest AAMR (17.90 per 100,000), followed by Black/African American (12.00), American Indian/Alaska Native (8.55), Hispanic (7.92), and Asian/Pacific Islander groups (5.95). Males exhibited an AAMR nearly four times higher than females in 2024 (27.63 vs. 7.04 per 100,000). Mortality increased with age, peaking among adults aged ≥85 years (63.80 per 100,000), followed by those aged 75–84 (24.82) and 65–74 years (6.73). Regionally, the Northeast experienced the greatest decline after 2012 (APC: –1.14%), whereas the South showed increasing mortality after 2019 (APC: +1.55%). Based on available urbanization data, non-metropolitan areas consistently had higher mortality compared to metropolitan regions. Conclusions: Bladder cancer mortality in the United States has declined modestly over the past two decades, though trends vary across race, sex, geography, age, and urbanization categories. Continued monitoring and targeted resource allocation may support improved outcomes in populations with persistently elevated mortality trends.
Nawab et al. (Sun,) studied this question.