Investigating the association between blue light cystoscopy utilization and social determinants of health.

Introduction: Blue light cystoscopy (BLC) improves bladder cancer (BCa) detection. No studies have evaluated socioeconomic inequity in the utilization of BLC.

Methods: An institutional bladder tumor (TURBT) database (2016-2023) was retrospectively reviewed and BLC and white light cystoscopy (WLC) recipients were compared. Demographic and insurance data were collected. Socioeconomic Status (SES) was determined using a validated national and Rhode Island Area Deprivation Index (ADI).

Results: 2122 Rhode Island patients underwent TURBT and 32.23% had BLC. BLC recipients were younger (mean age 71.5 vs 73.8 years,  < 0.001), more likely married (69.6% vs 57.2%,  < 0.001), more likely English speakers (93.3% vs 91.9%,  = 0.015), and more likely to have private insurance (34.2% vs 27%,  = 0.001). BLC recipients had less socioeconomic disadvantage ( < 0.001): lower mean National (36.2 vs 38.7) and State (4.8 vs 5.2) ADI.

Conclusion: SES is associated with BLC utilization, which may negatively influence BCa outcomes.