Elsevier

European Urology

Volume 71, Issue 1, January 2017, Pages 96-108
European Urology

Platinum Priority – Review – Bladder Cancer
Editorial by Marko Babjuk on pp. 109–110 of this issue
Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends

https://doi.org/10.1016/j.eururo.2016.06.010Get rights and content

Abstract

Context

Bladder cancer has become a common cancer globally, with an estimated 430 000 new cases diagnosed in 2012.

Objective

We examine the most recent global bladder cancer incidence and mortality patterns and trends, the current understanding of the aetiology of the disease, and specific issues that may influence the registration and reporting of bladder cancer.

Evidence acquisition

Global bladder cancer incidence and mortality statistics are based on data from the International Agency for Research on Cancer and the World Health Organisation (Cancer Incidence in Five Continents, GLOBOCAN, and the World Health Organisation Mortality).

Evidence synthesis

Bladder cancer ranks as the ninth most frequently-diagnosed cancer worldwide, with the highest incidence rates observed in men in Southern and Western Europe, North America, as well in certain countries in Northern Africa or Western Asia. Incidence rates are consistently lower in women than men, although sex differences varied greatly between countries. Diverging incidence trends were also observed by sex in many countries, with stabilising or declining rates in men but some increasing trends seen for women. Bladder cancer ranks 13th in terms of deaths ranks, with mortality rates decreasing particularly in the most developed countries; the exceptions are countries undergoing rapid economic transition, including in Central and South America, some central, southern, and eastern European countries, and the Baltic countries.

Conclusions

The observed patterns and trends of bladder cancer incidence worldwide appear to reflect the prevalence of tobacco smoking, although infection with Schistosoma haematobium and other risk factors are major causes in selected populations. Differences in coding and registration practices need to be considered when comparing bladder cancer statistics geographically or over time.

Patient summary

The main risk factor for bladder cancer is tobacco smoking. The observed patterns and trends of bladder cancer incidence worldwide appear to reflect the prevalence of tobacco smoking.

Introduction

Bladder cancer is the ninth most common cancer worldwide, with an estimated 430 000 new cases in 2012. More than 60% of all bladder cancer cases and half of all the 165 000 bladder cancer deaths occur in the less developed regions of the world. A strong male predominance is observed with three-quarters of all bladder cancer cases occurring in men [1].

While differences in the prevalence of tobacco smoking, the main risk factor for the disease [2], [3], explain much of these geographical and sex disparities worldwide, infection with Schistosoma haematobium reflects the high burden of the disease in parts of Northern and sub-Saharan Africa [4]. Equally, the scale of bladder cancer incidence can be greatly affected by registration practices with respect to the inclusion of noninvasive bladder tumours and multiple tumours of the urinary tract, as part of routine reporting [5].

This paper provides an overview of the most recent bladder cancer incidence and mortality patterns and trends using the Cancer Incidence in Five Continents series (CI5), GLOBOCAN, and World Health Organisation (WHO) Mortality databases held at the International Agency for Research on Cancer (IARC). We review the current understanding of the aetiology of the disease and the specific issues that govern registration and reporting of bladder cancer and how differences in such practices may impact the comparison of cancer incidence statistics.

Section snippets

Data sources

Regional and national bladder cancer incidence data and corresponding populations were extracted from the CI5 series online [6]. CI5 is the main source of global cancer incidence data provided by population-based cancer registries worldwide. The quality of data submitted to CI5 is evaluated by a rigorous editorial process, ensuring that compiled datasets reach the highest levels of validity, completeness, and comparability [7]. Beginning over 50 yr ago, the latest (10th) volume presents data

World

According to GLOBOCAN estimates, about 430 000 new bladder cancer cases and 165 000 bladder cancer deaths occurred worldwide in 2012, with 75% of the total burden occurring in men (Table 1). Substantial geographic variations can be observed, with 55% of all bladder cancer cases and 43% of bladder cancer deaths occurring in 20% of the world population living in very high Human Development Index (HDI) countries. In comparison, only 5% of the total bladder cancer burden occurred in low HDI

Conclusions

In this study, we presented the most recent patterns and trends of bladder cancer worldwide, observing the highest incidence rates of disease in countries with very high levels of human development in Europe and Northern America, but also, likely for differing reasons, in parts of Northern Africa and Western Asia. The burden was greater in men, yet diverging incidence trends by sex were observed in some countries, with rate declines in men and increases in women. Overall, bladder cancer

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