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Bladder cancer incidence increases with age, is higher in men, and is a major burden to the health systems because of the chronic nature of the most common non–muscle-invasive tumors.
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Cigarette smoking, occupational exposures, arsenic, Schistosoma haematobium infection, some medications, and genetic variation are the major risk factors associated with the disease.
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Further evidences are needed to establish the role of disinfection byproducts, fluid intake, urinary tract infections, diabetes,
Epidemiology of Bladder Cancer
Section snippets
Key points
The burden of the disease
Bladder cancer is mainly a disease of aging; its incidence and prevalence increase around the sixth decade and peak in the seventh to eighth decade of life. It is the ninth most common cancer, with 430,000 new cases diagnosed in 2012 worldwide; on average it is 3 to 4 times more common in men than in women. Incidence rates are highest in Europe, the United States, and Egypt (Fig. 1).1, 2 Substantial variation exists in the incidence of bladder cancer worldwide, because of differences not only
The causes of the disease: what is known?
Table 1 displays the factors/exposures for which conclusive evidence exists regarding their association with bladder cancer risk.
The causes of the disease: what needs to be confirmed (or refuted)
Table 1 also lists the factors/exposures for which suggestive or inconclusive evidence exists regarding their association with UBC. This section examines the most important ones in terms of frequency and impact.
Risk factors associated with urinary bladder cancer clinical characteristics and outcome
Because bladder cancer is often a chronic disease, some of the risk factors associated with the development of the initial tumor may also influence outcome. However, little research has been performed in this area, except in regard to smoking. A recent systematic review suggests that, in patients with NMIBC, smoking at diagnosis is associated with increased recurrence after primary treatment, whereas the evidence regarding its association with progression and mortality is weaker.60 Smoking
Summary
Substantial knowledge exists regarding the causes of bladder cancer, but thus far it has not had a major impact on disease incidence or mortality. Increased awareness about the role of smoking is needed at the population level. Additional suggestions for future directions are listed in Box 2.
References (71)
- et al.
GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase No. 11 [Internet]
(2013) - et al.
Estimates of global cancer prevalence for 27 sites in the adult population in 2008
Int J Cancer
(2013) - et al.
International variations in bladder cancer incidence and mortality
Eur Urol
(2014) - Available at: http://seer.cancer.gov/statfacts/html/urinb.html. Accessed August 4,...
- et al.
Bladder cancer
- et al.
The economics of bladder cancer: costs and considerations of caring for this disease
Eur Urol
(2014) - et al.
A molecular taxonomy for urothelial carcinoma
Clin Cancer Res
(2012) Understanding the gender disparity in bladder cancer risk: the impact of sex hormones and liver on bladder susceptibility to carcinogens
J Environ Sci Health C Environ Carcinog Ecotoxicol Rev
(2013)- et al.
The effect of age and gender on bladder cancer: a critical review of the literature
BJU Int
(2010) - et al.
Association between smoking and risk of bladder cancer among men and women
JAMA
(2011)
Smoking and bladder cancer in Spain: effects of tobacco type, timing, environmental tobacco smoke, and gender
Cancer Epidemiol Biomarkers Prev
Occupational risk factors
Scand J Urol Nephrol Suppl
A meta-analysis on the association between bladder cancer and occupation
Scand J Urol Nephrol Suppl
Occupational exposures to polycyclic aromatic hydrocarbons and respiratory and urinary tract cancers: an updated systematic review and a meta-analysis to 2014
Arch Toxicol
Arsenic in drinking water and urinary tract cancers: a systematic review of 30 years of epidemiological evidence
Environ Health
Epidemiology of urinary bladder cancer: from tumor development to patient's death
World J Urol
Cancer incidence and mortality after radioiodine treatment for hyperthyroidism: a population-based cohort study
Lancet
Environmental and heritable factors in the causation of cancer–analyses of cohorts of twins from Sweden, Denmark, and Finland
N Engl J Med
Most common ‘sporadic’ cancers have a significant germline genetic component
Hum Mol Genet
NAT2 slow acetylation, GSTM1 null genotype, and risk of bladder cancer: results from the Spanish Bladder Cancer Study and meta-analyses
Lancet
NAT2 slow acetylation and bladder cancer risk: a meta-analysis of 22 case-control studies conducted in the general population
Pharmacogenetics
GSTM1 null and NAT2 slow acetylation genotypes, smoking intensity and bladder cancer risk: results from the New England bladder cancer study and NAT2 meta-analysis
Carcinogenesis
Cumulative effect of genome-wide association study-identified genetic variants for bladder cancer
Int J Cancer
PharmGKB summary: very important pharmacogene information for N-acetyltransferase 2
Pharmacogenet Genomics
Alcohol, coffee, and bladder cancer risk: a review of epidemiological studies
Eur J Cancer Prev
Fluid intake and risk of bladder cancer in the Nurses' Health Studies
Int J Cancer
Total fluid and water consumption and the joint effect of exposure to disinfection by-products on risk of bladder cancer
Environ Health Perspect
Personal hair dye use and bladder cancer: a meta-analysis
Ann Epidemiol
The association between physical activity and bladder cancer: systematic review and meta-analysis
Br J Cancer
Plasma 25-hydroxyvitamin D(3) and bladder cancer risk according to tumor stage and FGFR3 status: a mechanism-based epidemiological study
J Natl Cancer Inst
Diet and bladder cancer: a meta-analysis of six dietary variables
Am J Epidemiol
Bladder cancer and exposure to water disinfection by-products through ingestion, bathing, showering, and swimming in pools
Am J Epidemiol
Water disinfection by-products and bladder cancer: is there a European specificity? A pooled and meta-analysis of European case-control studies
Occup Environ Med
Chronic inflammation and bladder cancer
Urol Oncol
Bladder cancer and seroreactivity to BK, JC and Merkel cell polyomaviruses: the Spanish bladder cancer study
Int J Cancer
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The authors have nothing to disclose.