Regional Disparities in Bladder Cancer Hospitalizations and Mortality in Brazil: A Nationwide Analysis Over the Last Decade
Júlia Larsen Dorcínio, Karen Klein, Eduarda Paiva Borsa, Mariana Schlindwein Afonso, Yasmin Marques LoureiroPURPOSE
Bladder cancer (BC) is a prevalent urinary tract neoplasm strongly associated with tobacco use, its main risk factor. In Brazil, this scenario is concerning, as the country has the third-cheapest cigarettes in South America, with an average price of US$1.32 per pack, according to a 2025 report by the WHO. Considering the socioeconomic impact of this neoplasm, this study aimed to analyze the epidemiological profile of BC in Brazil over the last decade.
METHODS
A time-series analysis was conducted using data from the Brazilian Unified Health System Hospital Information System between 2016 and 2025. Variables included the number of hospitalizations according to region and sex, in-hospital mortality rate, average hospitalization cost, age group, and race/ethnicity.
RESULTS
During the study period, 204,048 hospitalizations for BC were recorded in Brazil, predominantly among males, who accounted for 143,066 cases (70.1%). An increase in hospitalizations was observed, rising from 15,069 in 2016 to 27,133 in 2025, representing an 80.1% increase. The Southeast region accounted for most hospitalizations, with 114,784 cases (56.3%), while the North region had the lowest number, with 4,202 cases (2.1%). Regarding in-hospital mortality, a decreasing trend was identified throughout the historical series, with the highest rate observed in 2016 (6.85%) and the lowest in 2025 (5.48%). Regionally, the North presented the highest mortality rate (9.59%), whereas the Southeast had the lowest (5.86%). The average cost per hospitalization was US$399. Individuals older than 60 years represented 80.6% of hospitalizations. Regarding race/ethnicity, 53.5% of patients were White and 37.8% were Black or mixed-race individuals.
CONCLUSION
Regional disparities reflect structural inequalities in access to healthcare in Brazil. While the Southeast region, with greater healthcare availability, presented the highest number of hospitalizations and lower mortality rates, the North region, historically more vulnerable, recorded the highest in-hospital mortality. These findings suggest that healthcare limitations and restricted access to diagnosis influence clinical outcomes. Although mortality decreased over time, hospitalizations continued to rise, demonstrating that BC remains an important epidemiological and economic challenge.