657 Background: Bladder cancer typically presents after age 60, but cases diagnosed before age 60 (early-onset) may show distinct demographic and socioeconomic profiles. Using NIH All of Us, we characterized disparities in early- vs late-onset bladder cancer. Methods: Cross-sectional analysis of 1, 669 adults with incident bladder cancer in All of Us (Registered Tier) (early-onset <60, n=222; late-onset ≥60, n=1, 447). We compared age at diagnosis, sex, simplified race/ethnicity (White, Hispanic, Black, Asian, Other), and neighborhood-level socioeconomic z-scores (median income, high-school completion, poverty, assisted-income reliance, uninsured rate, vacant housing, deprivation index, composite SES). Categorical variables were analyzed with χ² tests; continuous (age and SES z-scores) with Welch t-tests. Results: Early-onset patients were younger (mean age 52. 3 vs. 71. 4 years; p<0. 001), more often female (38. 3% vs. 26. 7%; p = 0. 0012), and more Hispanic (16. 7% vs. 5. 7%; p<0. 001), Black (17. 1% vs. 5. 3%; p < 0. 001), and Asian (3. 2% vs. 0. 7%; p<0. 001), with fewer White (57. 2% vs. 80. 4%; p<0. 001). Neighborhood deprivation (deprivation index +0. 22 vs. –0. 03; p<0. 001), uninsurance (+0. 21 vs. –0. 03; p = 0. 0015), and poverty (+0. 17 vs. –0. 03; p = 0. 0074) z-scores were higher, while median income (–0. 14 vs. +0. 02; p = 0. 024) and high-school completion (–0. 20 vs. +0. 03; p = 0. 002) were lower. Conclusions: Early-onset bladder cancer is enriched for women and racial/ethnic minorities and clusters in disadvantaged areas. These differences implicate social determinants–limited health care access, occupational/environmental exposures, and economic hardship, may accelerate onset in vulnerable populations, underscoring targeted prevention and earlier detection. Demographic, race/ethnicity, and socioeconomic characteristics of early- vs late-onset bladder cancer, All of Us research program (N = 1, 669). Category Feature EarlyOnset (n = 222) LateOnset (n = 1447) p-value Ethnicity/Race Hispanic 16. 7% 5. 7% < 0. 001 White 57. 2% 80. 4% < 0. 001 Other or unknown 5. 9% 7. 9% < 0. 001 Black 17. 1% 5. 3% < 0. 001 Asian 3. 2% 0. 7% < 0. 001 Demographics Female 38. 3% 26. 7% 0. 001 Other or unknown 1. 30% 1. 10% 0. 001 Male 60. 4% 72. 2% 0. 001 Socioeconomic No health insurance 0. 21 ± 1. 08 -0. 03 ± 0. 98 0. 001 SES composite index 0. 12 ± 0. 63 -0. 02 ± 0. 61 0. 001 High School education -0. 20 ± 1. 03 0. 03 ± 0. 99 0. 001 Assisted income 0. 19 ± 1. 05 -0. 03 ± 0. 99 0. 01 Poverty 0. 17 ± 1. 03 -0. 03 ± 0. 99 0. 01 Median income <jats: td colspan="1" rows
Zhang et al. (Sun,) studied this question.