EPIDEMIOLOGY AND LONG-TERM SURVIVAL AMONG PATIENTS WITH LOCALLY ADVANCED OR METASTATIC UROTHELIAL CARCINOMA (LA/MUC): RESULTS OF A SWEDISH NATIONWIDE LONG-TERM CASE-CONTROL STUDY
Author(s)
Markus Aly, MD, PhD1, Jakob Börsum, MSc2, Fraence Hardtstock, MSc3, Suzanne Bergman, MSc4, Petra Skare, PhD4, Mairead Kearney, MB, BCh, MPH, MBA, MSc Econ5.
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden, 2Cytel Inc., Stockholm, Sweden, 3Cytel Inc., Berlin, Germany, 4Merck AB, an affiliate of Merck KGaA, Solna, Sweden, 5Merck Healthcare KGaA, Darmstadt, Germany.
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden, 2Cytel Inc., Stockholm, Sweden, 3Cytel Inc., Berlin, Germany, 4Merck AB, an affiliate of Merck KGaA, Solna, Sweden, 5Merck Healthcare KGaA, Darmstadt, Germany.
OBJECTIVES: There are limited contemporary data regarding the epidemiology and outcomes of la/mUC, an aggressive malignancy with historically poor prognosis. National-level registry data were used to analyze epidemiological trends and survival outcomes in patients with la/mUC in Sweden.
METHODS: This retrospective longitudinal cohort study used pseudonymized patient-level data from Swedish registers. Adult patients with la/mUC were identified from the National Cancer Register (cases) and matched to controls by age, sex, and region of residence. Crude and age-standardized incidence (2006-2020) and prevalence (2005-2020) were calculated annually, overall, and by age group and gender. Overall survival was evaluated among incident cases and matched controls using Kaplan-Meier methodology and Cox regression analyses.
RESULTS: Overall crude incidence increased from 1.0 per 100,000 persons in 2006 to 2.5 per 100,000 persons in 2020. When stratified by age group and gender, incidence increased with increasing age group and was considerably higher in males than females (3.3 vs 1.7 per 100,000 in 2019). Prevalence increased from 0.4 per 100,000 persons in 2005 to 6.7 per 100,000 in 2020 and remained higher among males (9.3 vs 4.0 per 100,000 in 2020). Of 2,026 patients with la/mUC included, mean age was 73 years, 67% male, with a mean Charlson Comorbidity Index score of 1.9. Patients with la/mUC had significantly higher mortality versus matched controls (HR=9.6; 95% CI: 8.9-10.4). Median overall survival was 8.6 months in cases versus 165.0 months in controls (>13 years).
CONCLUSIONS: The results of this population-based study suggest an increase in the incidence and prevalence of la/mUC in Sweden over time with a predominance of male patients, in line with worldwide trends. In addition, all-cause mortality was higher relative to a demographically-matched comparison group. Further research is needed to better understand how real-world factors including the increased use of approved newer therapies, impact epidemiological rates and survival.
METHODS: This retrospective longitudinal cohort study used pseudonymized patient-level data from Swedish registers. Adult patients with la/mUC were identified from the National Cancer Register (cases) and matched to controls by age, sex, and region of residence. Crude and age-standardized incidence (2006-2020) and prevalence (2005-2020) were calculated annually, overall, and by age group and gender. Overall survival was evaluated among incident cases and matched controls using Kaplan-Meier methodology and Cox regression analyses.
RESULTS: Overall crude incidence increased from 1.0 per 100,000 persons in 2006 to 2.5 per 100,000 persons in 2020. When stratified by age group and gender, incidence increased with increasing age group and was considerably higher in males than females (3.3 vs 1.7 per 100,000 in 2019). Prevalence increased from 0.4 per 100,000 persons in 2005 to 6.7 per 100,000 in 2020 and remained higher among males (9.3 vs 4.0 per 100,000 in 2020). Of 2,026 patients with la/mUC included, mean age was 73 years, 67% male, with a mean Charlson Comorbidity Index score of 1.9. Patients with la/mUC had significantly higher mortality versus matched controls (HR=9.6; 95% CI: 8.9-10.4). Median overall survival was 8.6 months in cases versus 165.0 months in controls (>13 years).
CONCLUSIONS: The results of this population-based study suggest an increase in the incidence and prevalence of la/mUC in Sweden over time with a predominance of male patients, in line with worldwide trends. In addition, all-cause mortality was higher relative to a demographically-matched comparison group. Further research is needed to better understand how real-world factors including the increased use of approved newer therapies, impact epidemiological rates and survival.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH26
Topic
Clinical Outcomes, Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology