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Cancer. Author manuscript; available in PMC 2017 July 01. Published in final edited form as: Cancer. 2016 July 1; 122(13): 2012–2020. doi:10.1002/cncr.30029.

Gender disparities in chemotherapy use and survival in patients with advanced bladder cancer Tracy L. Rose, M.D. M.P.H.1, Allison M. Deal, M.S.2, Matthew E. Nielsen, M.D. M.S.3, Angela B. Smith, M.D. M.S.3, and Matthew I. Milowsky, M.D.1 1Division

of Hematology/Oncology, Department of Medicine, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC

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2Biostatistics

and Clinical Data Management Core, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC

3Urologic

Oncology Program, Department of Urology, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC

Abstract Background—Women with advanced bladder cancer have inferior survival compared to men. However, women treated on clinical trials do not have a survival disadvantage. Less frequent administration of systemic chemotherapy in women with advanced bladder cancer may contribute to their inferior survival.

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Methods—We identified patients with stage IV bladder cancer from 1998–2010 using the National Cancer Data Base (NCDB), a national outcomes database that includes 70% of all newly diagnosed cancer cases in the United States. Gender differences in demographics, systemic chemotherapy administration, and overall survival (OS) were compared. Results—23,981 patients were identified (35% female). Compared with men, women were older, more likely to be black, and less likely to be insured (p