Abstract B001: Urinary bladder cancer incidence and mortality in the United States: 20-year trends and initial impact of the COVID-19 pandemic

Abstract Introduction: We examined nationwide trends in urinary bladder cancer incidence and mortality focusing on 1999-2019. A separate analysis of data from 2020 revealed how these rates were affected by the onset of the COVID-19 pandemic. Methods: State-specific bladder cancer (in situ and invasive) incidence and mortality rates were ascertained from the United States (US) Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database for 1999-2020 overall and according to age, gender, and geographic region. All rates were age-adjusted to the 2000 US Census population, except age-specific rates. We used Joinpoint software to calculate the 20-year average annual percent change and annual percent change for specific periods identified by data-driven joinpoint placement with 95% confidence intervals (CI). Results: In 2019, the US bladder cancer incidence rate was 18. 8 (CI, 18. 6 to 18. 9) cases per 100, 000. Bladder cancer incidence decreased 0. 9% annually (CI, 0. 8 to 1. 0% decrease) during 1999-2019, with a 3. 3% annual decrease (CI, 2. 5 to 4. 1% decrease) during 2016-2019 specifically. Among men, the 20-year annual decrease was 1. 1% (CI, 1. 0 to 1. 1% decrease), with a 3. 8% annual decrease (CI, 2. 8 to 4. 6% decrease) during 2017-2019 specifically. Among women, the 20-year annual decrease was 1. 0% (CI, 0. 9 to 1. 2% decrease), with a 2. 6% annual decrease (CI, 1. 7 to 4. 2% decrease) during 2016-2019 specifically. Largest annual decreases in incidence rates were seen among 55-59-year-olds (1. 8%, CI, 1. 6 to 2. 0% decrease), and in the western US (2. 3%, CI, 2. 0 to 2. 6% decrease). Conversely, some southern states showed an increase in incidence. In Tennessee, there was a 20-year annual increase of 1. 2% (CI, 0. 9 to 1. 6% increase). In 2019, the US bladder cancer mortality rate was 4. 1 (CI, 4. 0 to 4. 2) deaths per 100, 000. Bladder cancer mortality decreased 0. 4% annually (CI, 0. 2 to 0. 5% decrease) during 1999-2019, with a 2. 5% annual decrease (CI, 1. 3 to 4. 7% decrease) during 2016-2019 specifically. Mortality rate trends were generally similar among men and women (0. 4% and 0. 7% decrease annually, respectively). Largest annual decreases in mortality rates were seen among 50-54-year-olds (1. 5%, CI, 0. 6 to 2. 4% decrease) and in the northeast US (0. 8%, CI, 0. 7 to 1. 0% decrease). Reflecting the initial impact of the COVID-19 pandemic, bladder cancer incidence decreased by 8. 6% (CI, 7. 7 to 9. 6% decrease) and bladder cancer mortality decreased by 2. 7% (CI, 0. 6 to 4. 8% decrease) comparing 2020 with 2019. Conclusions: After decades remaining relatively constant, bladder cancer incidence and mortality rates in the US began to decrease around 2016-2017. This trend was less apparent in the southern part of the country, where incidence trended upward in some states. As evident for other common cancers, bladder cancer incidence rates decreased sharply during the first year of the COVID-19 pandemic. Forthcoming data for 2021-2024 will provide a clearer picture of the magnitude of this disruption and the possibility of a rebound. Citation Format: Grace B. Gallant, Hugo Pomares-Millan, Judy R. Rees, Margaret R. Karagas, Michael N. Passarelli. Urinary bladder cancer incidence and mortality in the United States: 20-year trends and initial impact of the COVID-19 pandemic abstract. In: Proceedings of the AACR Special Conference on Bladder Cancer: Transforming the Field; 2024 May 17-20; Charlotte, NC. Philadelphia (PA): AACR; Clin Cancer Res 2024;30 (10Suppl): Abstract nr B001.