Occupational disparities in bladder cancer survival: A population-based cancer registry study in Japan

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.