Background

Question 1

How prevalent is bladder cancer in the United States?

Answer 1

Bladder cancer is the 4th most commonly diagnosed cancer in men behind prostate, lung, and colorectal malignancies, but it is only the 11th most common cancer in women.

Question 2

How many cases are diagnosed and how many deaths occur annually in the United States?

Answer 2

There are ∼77,000 cases of bladder cancer and ∼16,000 deaths annually.

Question 3

What are common risk factors for bladder cancer?

Answer 3

Common risk factors include:

Smoking

Occupational chemical exposures (paint, dye, metal, and petroleum products)

Chronic bladder irritation (Chronic cystitis, indwelling catheters, etc.)

Prior pelvic irradiation or chemo (cyclophosphamide)

Schistosoma haematobium infection (associated only with SCC)

Question 4

What is the median age at Dx?

Answer 4

The median age is 69 yrs in men and 71 yrs in women.

Question 5

What is the most common histologic subtype in developed and developing countries?

Answer 5

In developed countries, ∼90% of bladder cancers are urothelial carcinomas, formerly called transitional cell carcinomas. In countries where schistosomiasis is endemic, SCC is more common.

Question 6

What are the different histopathologic types of bladder cancer in order of decreasing frequency?

Answer 6

The most common histology in the United States is urothelial carcinoma (94%) > SCC (3%) > adenocarcinoma (2%) > neuroendocrine tumors (1%).

Question 7

What % of newly detected bladder tumors are Ta/Tis/T1 lesions?

Answer 7

∼70% of bladder cancers are superficial bladder tumors, with 70% of these confined to the mucosa (Ta/Tis) and 30% confined to the submucosa (T1).

Question 8

What % of pts have DMs at Dx?

Answer 8

∼4% have metastatic Dz at presentation, usually involving bones, lungs, or liver.