Factors affecting recurrence rates in superficial bladder cancer

A prospective study of all patients with superficial bladder cancer diagnosed in Northern Alberta (population 1.2 million) from 1977 to 1983 was performed to establish patterns of recurrence. Of the 761 patients with all stages of bladder cancer at diagnosis, 642 were deemed to be free of disease after primary treatment consisting of transurethral resection, fulguration, or laser surgery. Follow-up of these patients showed that approximately two-thirds of first recurrences occur within 18 months of diagnosis and that more of these patients have died of unrelated causes (n = 73) than of bladder cancer (n = 34). Censored disease-free interval comparisons showed that initial recurrences occurred sooner in patients with multifocal rather than unifocal disease and also sooner in females than in males. Known risk factors (occupational exposure to chemicals and cigarette smoking) and suspected risk factors (coffee consumption and artificial sweetener use) had no effect on disease-free interval and are not related to tumor multiplicity.