Abstract
BACKGROUND: Little is known about occupational disparities in bladder cancer survival. METHODS: Using data from a population-based cancer registry (1970-2016), we identified 3593 patients with incident bladder cancer diagnosed during 1970-2011 who completed occupational information. The patients were followed for 5 years (median follow-up time 5.0 years). Their longest-held occupations at incident bladder cancer diagnosis were classified according to a national standardized classification. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall death were estimated by Cox proportional hazard model, adjusted for age, sex, and year of diagnosis. Clerical workers served as the reference group. RESULTS: Overall prognosis was fair in this population (5-year overall survival, 61.9%). Compared with patients in clerical jobs, survival was poorer for those in professional and managerial jobs (mortality HR 1.36; 95% CI 1.09-1.69), sales and service jobs (HR 1.25, 95% CI 1.01-1.56), construction jobs (HR 1.83, 95% CI 1.40-2.38), and manufacturing jobs (HR 1.32, 95% CI 1.05-1.66), as well as those not actively employed (HR 1.27, 95% CI 1.02-1.58). A similar pattern was observed in the subgroup analyses restricted to male patients as well as additional analyses adjusted for potential prognostic variables (eg, stage) with multiple imputation. CONCLUSION: We documented occupational disparities in bladder cancer survival in Japan. However, the pattern of disparity did not favor highest occupational groups.