An evolving approach to the surgical management of superficial bladder carcinoma

Malignant epithelial tumors of the urinary bladder are the fourth most common cancer among men, excluding squamous cell cancer of the skin, and are diagnosed in over 50,000 patients each year. Although the ratio is decreasing somewhat, bladder cancer is three times as common in males than in females and is responsible for over 10,000 deaths annually. White males may have an increased risk compared to Afro-American males though this appears to be true for superficial disease only. Well-documented risk factors for the disease include cigarette smoking, chemical carcinogens, schistosomiasis and chronic urinary tract infections, and a wide variety of occupations concentrated in the chemical, dye, rubber, and textile industries. Occupational exposure appears to be a contributory factor for the disease in nearly 25% of the male population in the United States with bladder carcinoma.