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Published on: December 28, 2021
Changing patterns of bladder cancer in the USA: evidence of heterogeneous disease
Yawei Zhang1, Cairong Zhu, Maria Paula Curado
1School of Public Health, Yale University, New Haven, CT 06520, USA. yawei.zhang@yale.edu
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.
