Trends in surgical procedures for bladder cancer within the Brazilian public health system: An 11-year analysis.

Abstract

Background: Continuous updates to procedures and hospital admissions for bladder cancer (BC) are crucial for understanding trends, particularly within Brazil's public health system. Monitoring these data is vital for informed decision-making.

Objective: The objective of the study was to understand the trends in surgical procedures for BC within the Brazilian public health system.

Methods: Data were collected from the Brazilian Data Center for the Public Health System, focusing on hospital admissions related to bladder surgeries from 2013 to 2023. Information was categorized in terms of procedure urgency, hospitalization duration, costs, and mortality rates.

Results: A total of 123,434 BC-related surgical procedures were performed, the majority of which were elective (73.4%) and bladder-preserving (BP, 96.2%). There were 1,710 reported mortalities, with a consistent procedure-specific mortality rate (PSMR) across the 11-year period for all procedures. The average hospitalization duration for elective BP (β = -0.12, p < 0.001), elective non-BP (β = -0.46, p < 0.001), and urgent non-BP procedures (β = -0.41, p = 0.012) steadily decreased. Elective and urgent BPs showed the lowest annual PSMRs (0.66% and 4.25%, respectively), compared to elective and urgent non-BPs (6.93% and 10.72%). The northern and northeastern regions reported significantly fewer cases but higher mortality rates after 2018, despite reduced average hospital stays. While hospital costs for these procedures increased, the standalone costs of surgical interventions remained stable over the 11-year period.

Conclusion: BC-related hospital admissions, particularly for BP procedures, have increased, reflecting improved access to healthcare. However, regional disparities in surgical care, mortality rates, and hospital stays persist across Brazil.