Changing patterns of bladder cancer in the USA: evidence of heterogeneous disease

BJU Int. 2012 Jan;109(1):52-6. doi: 10.1111/j.1464-410X.2011.10283.x. Epub 2011 May 18.

Abstract

Objective: To test the hypothesis that bladder cancer is a heterogeneous disease.

Patients and methods: We examined the temporal trends of bladder cancer by histological subtype and by disease stage and grade using the National Cancer Institute's Surveillance, Epidemiology, and End Results data collected in 1973-2007.

Results: The age-adjusted incidence rates of bladder cancer showed a slight decrease from 1973 to 2007 (annual percentage change [APC] = -0.4, P < 0.05). Although the age-adjusted incidence rates of non-papillary transitional cell carcinoma decreased by about 53% from 7.9 per 100,000 in 1973 to 3.7 per 100,000 in 2007 (APC = -2.2, P < 0.05), the age-adjusted incidence rates of papillary transitional cell carcinoma increased by about 56% from 6.8 per 100,000 in 1973 to 10.6 per 100,000 in 2007 (APC = 0.5, P < 0.05). Among other rare histological subtypes, except for small cell carcinoma which showed a slightly rising trend, squamous cell carcinoma, adenocarcinoma and others all presented a decreasing trend. Similar patterns were found for different stages (localized, regional and distant), but a dramatic increasing trend of grade IV was found between 1998 and 2007 when a corresponding decreasing trend was shown for grades I, II and III.

Conclusion: The results support the hypothesis that bladder cancer is a heterogeneous disease and taking disease heterogeneity into consideration in future epidemiological studies is essential.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Factors
  • Carcinoma, Transitional Cell / epidemiology
  • Carcinoma, Transitional Cell / pathology*
  • Cluster Analysis
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Staging*
  • Prognosis
  • Retrospective Studies
  • SEER Program*
  • Survival Rate / trends
  • Time Factors
  • United States / epidemiology
  • Urinary Bladder Neoplasms / epidemiology
  • Urinary Bladder Neoplasms / pathology*