National trends and disparities in bladder cancer mortality associated with tobacco use between 1999 and 2020.

656 Background: Bladder Cancer is one of the most serious types of cancer that can lead to death, especially when it’s combined with tobacco use. We aim to assess the trends in bladder cancer mortality associated with tobacco use in the U.S. Methods: Nationwide mortality records were obtained from the CDC-WONDER database from 1999–2020 among U.S. adults > 25 years with bladder cancer (ICD-10 code: C67) and tobacco use (ICD-10 code: F17). Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) were calculated per 100,000 population and stratified by demographic variables. Joinpoint regression analysis was used to determine average and annual percent change (AAPC and APC). Results: From 1999 to 2020, a total of 50,560 deaths were reported among individuals aged 25 years and older with bladder cancer and tobacco use in the U.S. The AAMR significantly increased from 0.1 in 1999 to 1.45 in 2020 (AAPC: 15.85; p< 0.000001). Gender-stratified analysis revealed that men had a higher overall AAMR (1.87) with an AAPC: 16.0; p < 0.000001 than women (0.36) with an AAPC: 14.54; p < 0.000001. Regionally, the highest overall AAMR was noticed in the Midwest (1.36), followed by the Northeast (1.16). Racially, the highest overall AAMR was noticed in NH White (1.22) (AAPC: 16.69; 95% CI: 13.14 to 20.35; p > 0.000001) while the overall AAMR in Hispanics was (0.34) (AAPC: 5.13; 95% CI: 2.17 to 8.18; p = 0.0006. The non-metropolitan areas had a higher overall AAMR (1.4) compared to the metropolitan areas (0.99). Conclusions: Trends in bladder cancer associated with tobacco use in adults increased from 1999 to 2020. Higher trends were observed in men, the Northeast, NH White, and non-metropolitan areas, emphasizing the need for targeted interventions and specific management plans. Data for bladder cancer and tobacco use-related mortality in U.S. adults between 1999 and 2020. Variable Deaths (n) AAMR (95% CI) Overall 50,560 1.06 (1.05-1.07) Hispanics 1,024 0.3 (0.28-0.32) NH Blacks 2,456 0.56 (0.53-0.58) NH Whites 46,470 1.22 (1.21-1.23) Metropolitan Areas 38,617 0.99 (0.98-1.0) Non-Metropolitan Areas 11,943 1.4 (1.38-1.43) Men 40,156 2.02 (2.0-2.05) Women 10,404 0.38 (0.37- 0.38)