Bladder Cancer Epidemiology

Abstract

Bladder cancer (BC) is a worldwide health problem. In 2006 in Europe, there were an estimated 104,400 incident cases of BC diagnosed (82,800 in men and 21,600 in women) that represent a 6.6% of the total cancers in men and 2.1% in women.

Tobacco use is a major preventable cause of death, and especially involved with BC carcinogenesis. Tobacco smoking is the most well-established risk factor for BC, causing around 50%–65% of male cases and 20%–30% of female cases.

Occupational exposure has been considered the second most important risk factor for BC. Work related cases account for a 20%–25% of all BC cases in several series.

In addition, chronic urinary tract infection had been related to BC, particularly, with invasive squamous cell carcinoma. Bladder schistosomiasis has particularlybeen considered by the international agency for research on cancer (IARC) as a definitive cause or urinary BC with an associated fivefold risk.

BC is a disease of the environment and age. Populations are increasing in number, and they are growing old as well.,. Since more people are living longer, more are at potential risk. Furthermore, the changing environments in developed and developing countries are causing more carcinogen concentration than can be associated to genesis of BC. Several carcinogens have been correlated to BC carcinogenesis.

However, it has been proposed that other environmental factors could affect the incidence on urothelial tumors. In fact, as for many other cancers, molecular researchers try to establish genetic alterations linked to carcinogenesis that could justify genetic predisposition.

Cancer is a major public health problem. At the end of the twentieth century, more than 930,000 people died of cancer every year in 15 member countries of the European Union (EU) (Coleman et al.). Using population projections, if the age-specific death rates remain constant, the absolute number of cancer deaths in 2015 will increase to 140,500 (Boyle and Ferlay 2005). BC is a worldwide health problem. In 2006 in Europe, there were an estimated 104,400 incident cases of BC diagnosed (82,800 in men and 21,600 in women) that represent a 6.6% of the total cancers in men and 2.1% in women. The estimated ratio by gender was 3.8:1, respectively. In men BC was the fourth most common cancer. Bladder cancer represents a 4.1% of total deaths for cancer in men and 1.8% of total deaths in women (Ferlay et al. 2007). In the EU overall (27 countries), BC mortality rates were stable up to early 1990s, and declined, thereafter, by 16% in men and 12% in women, to reach values of 6 and 1.3/100,000, respectively, in the early years of the present decade. The only countries without declining mortality are Croatia and Poland in both sexes, Romania in men, and Denmark in women. This documented and quantified reduction in BC mortality seems related to decrease in tobacco smoking, while its relationship with other risk factors remains controversial (Ferlay et al. 2008).