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Lessons from a population-based bladder cancer registry: exploring why survival is not improving
Jake A Tempo1,2, Samuel Sii3, Joseph Ischia2
1College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
BJU International
|February 27, 2024
Summary
Bladder cancer survival has declined over 40 years, primarily due to an aging population. Increased diagnoses in older individuals contribute to this trend, impacting overall survival rates.
Area of Science:
- Oncology
- Epidemiology
- Public Health
Background:
- Bladder cancer survival rates have shown a concerning decrease over the past four decades.
- Understanding the factors contributing to this decline is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the reasons behind the observed decrease in bladder cancer survival over a 40-year period.
- To analyze trends in bladder cancer incidence and survival in relation to demographic changes.
Main Methods:
- Utilized data from the South Australian Cancer Registry spanning January 1977 to December 2020.
- Included 8356 patients diagnosed with invasive bladder cancer (≥pT1 disease).
- Analyzed changes in incidence, age at diagnosis, and survival, adjusting for age and other factors.
Main Results:
- Invasive bladder cancer incidence decreased, but the mean age at diagnosis increased significantly (from 68 to 76 years).
- Overall survival decreased, but this trend reversed after adjusting for age, indicating age as a key factor.
- No significant change in bladder cancer-specific death rates was observed in older individuals, despite a decrease in non-cancer-specific deaths.
Conclusions:
- The decrease in invasive bladder cancer survival is significantly influenced by the aging population structure.
- While overall incidence has declined, the rise in diagnoses among older individuals is a primary driver of reduced survival rates.
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