Table 3. Multivariable Analysis of Adherence to Current Screening and Treatment Guidelines.
| Variable | OR (95% CI) | ||||
|---|---|---|---|---|---|
| ≤2 Cystoscopies | ≤1 Cytologic test | ≤1 Upper tract imaging | Absence of BCG | Absence of chemotherapya | |
| Age range, y | |||||
| 66-70 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 71-75 | 1.02 (0.92-1.14) | 0.93 (0.83-1.03) | 0.94 (0.85-1.05) | 0.98 (0.86-1.13) | 1.11 (0.98-1.27) |
| 76-80 | 1.23 (1.10-1.37) | 0.98 (0.87-1.09) | 1.02 (0.91-1.14) | 1.00 (0.87-1.16) | 0.97 (0.86-1.11) |
| 81-85 | 1.52 (1.36-1.69) | 1.14 (1.03-1.28) | 1.10 (0.99-1.23) | 1.13 (0.98-1.30) | 1.19 (1.05-1.35) |
| Sex | |||||
| Female | 0.70 (0.64-0.76) | 0.81 (0.74-0.88) | 0.84 (0.77-0.91) | 0.95 (0.85-1.06) | 1.37 (1.23-1.51) |
| Male | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Race and ethnicity | |||||
| Black | 1.41 (1.14-1.74) | 1.09 (0.88-1.35) | 1.36 (1.11-1.67) | 0.75 (0.59-0.96) | 0.67 (0.54-0.84) |
| Hispanic | 1.70 (1.14-2.53) | 0.80 (0.55-1.17) | 0.83 (0.58-1.19) | 0.89 (0.56-1.41) | 1.01 (0.65-1.56) |
| White | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Other | 1.13 (0.92-1.39) | 0.88 (0.72-1.09) | 0.85 (0.70-1.05) | 0.80 (0.62-1.02) | 0.86 (0.68-1.09) |
| Marital status | |||||
| Single | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Married | 0.69 (0.61-0.77) | 0.83 (0.74-0.93) | 0.91 (0.82-1.02) | 0.82 (0.70-0.95) | 1.03 (0.90-1.18) |
| Unknown | 0.81 (0.72-0.92) | 0.91 (0.81-1.04) | 0.93 (0.82-1.05) | 0.94 (0.79-1.11) | 0.84 (0.73-0.98) |
| Census region | |||||
| Midwest | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Northeast | 1.40 (1.26-1.57) | 0.54 (0.48-0.60) | 0.84 (0.75-0.93) | 1.11 (0.96-1.28) | 1.17 (1.03-1.34) |
| South | 0.70 (0.62-0.80) | 0.53 (0.47-0.61) | 0.63 (0.54-0.70) | 1.65 (1.37-1.98) | 0.81 (0.70-0.94) |
| West | 0.80 (0.73-0.89) | 0.80 (0.72-0.89) | 0.56 (0.50-0.62) | 1.02 (0.89-1.16) | 1.33 (1.17-1.50) |
| Median household income, $ | |||||
| ≤42 992 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 42 993-56 188 | 0.92 (0.83-1.02) | 0.89 (0.80-0.99) | 0.94 (0.85-1.04) | 0.95 (0.84-1.09) | 1.02 (0.90-1.15) |
| 56 189-73 827 | 0.89 (0.80-1.00) | 0.80 (0.71-0.89) | 0.96 (0.86-1.07) | 1.01 (0.87-1.16) | 1.13 (0.99-1.29) |
| ≥73 828 | 0.86 (0.75-0.99) | 0.77 (0.67-0.89) | 1.01 (0.89-1.16) | 1.01 (0.85-1.20) | 1.05 (0.89-1.23) |
| High school educational level, %b | |||||
| ≤20.58 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 20.59-27.36 | 0.99 (0.89-1.10) | 1.09 (0.97-1.21) | 1.13 (1.01-1.26) | 0.87 (0.75-1.00) | 0.90 (0.79-1.03) |
| 27.37-34.83 | 1.04 (0.92-1.17) | 1.20 (1.06-1.36) | 1.03 (0.91-1.16) | 0.83 (0.71-0.97) | 0.91 (0.79-1.06) |
| ≥34.84 | 1.01 (0.89-1.16) | 1.25 (1.09-1.44) | 0.97 (0.85-1.10) | 0.87 (0.73-1.04) | 0.88 (0.75-1.03) |
| Charlson Comorbidity Index score | |||||
| 0 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 1 | 1.03 (0.95-1.12) | 0.94 (0.86-1.03) | 0.93 (0.85-1.01) | 0.96 (0.86-1.07) | 1.32 (1.19-1.46) |
| 2 | 1.27 (1.14-1.42) | 1.11 (0.99-1.24) | 0.84 (0.75-0.94) | 1.00 (0.87-1.16) | 1.48 (1.29-1.70) |
| ≥3 | 1.57 (1.41-1.75) | 1.17 (1.05-1.30) | 0.84 (0.76-0.94) | 1.25 (1.08-1.44) | 1.46 (1.28-1.66) |
| Year of diagnosis | |||||
| 2004-2008 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 2009-2013 | 0.93 (0.86-1.00) | 0.66 (0.61-0.71) | 0.87 (0.91-1.04) | 1.25 (1.13-1.38) | 0.85 (0.78-0.93) |
Abbreviations: BCG, bacillus Calmette-Guérin; OR, odds ratio.
a
Intravesical chemotherapy.
b
Educational level was based on the proportion of residents within a patient’s zip code who were older than 25 years with at least a high school diploma.