Bladder cancer prevalence and incidence

In 2020, approximately 725,549 patients were living with bladder cancer in the United States, with an additional 82,290 new bladder cancer cases projected to be diagnosed in 2023.2 Based on SEER data from 2013 to 2019, 5% are estimated to have metastatic disease.2

According to 2023 SEER data, bladder cancer has the sixth-highest incidence and ranks seventh in the number of deaths among cancer diagnoses in the United States, with an estimated 16,710 disease-related deaths.2 By the time bladder cancer reaches the metastatic stage, survival rates point to a poor prognosis for patients.

Based on SEER data from 2013—2019: Bladder Cancer 5-year Survival Rate1

CI = confidence interval.

2013–2019 data are the most current available and do not reflect the latest changes in treatment practice.

 

RELATIVE SURVIVAL RATES BY TIME SINCE DIAGNOSIS, 2000–20193

In mUC

The 1-year relative survival rate was 28.9% (95% CI, 28.2-29.7)
and 3-year relative survival rate was 10.0% (95% CI, 9.4-10.5).1
Error bars represent 95% Cl.
 

The course of mUC treatment

A retrospective study examined electronic health record data of 8,183 patients who were diagnosed with advanced bladder cancer between 2011 and 2020.4

Select patient characteristics4

  • Median age at diagnosis of advanced urothelial carcinoma was 73.
  • 73.2% of patients were male.
  • Most patients were White (70.6%), 4.1% were Black or African American, and 15.3% were either Asian, Hispanic/Latino, or Other.

Treatment patterns of 8,183 patients4

Number of patients treated or not treated by line of systemic therapy

What can be done to address this current state of advanced bladder cancer care? It may start with higher awareness of the earlier signs of disease.

What risk factors and symptoms are associated with bladder cancer?

Understanding risk factors and diagnosing at earlier stages may help improve outcomes.

Risk factors

Age The risk of bladder cancer increases with age. Approximately 9 of 10 people who are diagnosed with bladder cancer are over the age of 55. The average age at diagnosis is 73.5,6

Gender Bladder cancer is the fourth most common cancer in men, but is less common in women. The chance men will develop bladder cancer in their lifetime is about 1 in 28; for women the chance is about 1 in 91.5

Race and Ethnicity White people are about twice as likely to develop bladder cancer as African American or Hispanic people. Asian Americans and Native Americans have slightly lower rates. The reason for these differences are not well understood.6

Smoking Smoking is the most important risk factor for bladder cancer. Smokers are at least 3 times more likely to get bladder cancer as nonsmokers, and smoking causes about half of all bladder cancers.6

Symptoms related to urothelial carcinoma

Advanced bladder cancer presents its own set of symptoms; clinicians must remain vigilant.

Currently, no major professional organizations recommend routine screening for bladder cancer among asymptomatic adults.7 However, it is important to be aware of symptoms.

Clinical presentation of bladder cancer may include urinary frequency, urgency, nocturia, or dysuria. Obstructive symptoms may occur if the tumor is near the bladder neck or urethra.7

Hematuria may be an early sign of bladder cancer, but may also be present due to benign causes such as infections. Urinalysis can identify hematuria but is generally not considered useful for routine screening.8

Symptoms of advanced bladder cancer to look for include7:

  • Abdominal, bone, flank, or pelvic pain
  • Anorexia
  • Cachexia
  • Lower-extremity edema
  • Renal failure
  • Respiratory symptoms
  • Suprapubic palpable mass
 

MONITORING FOR UROTHELIAL CARCINOMA SYMPTOMS

Recognizing these symptoms is vital when monitoring earlier stages of bladder cancer, which may allow for earlier care that could potentially make a difference in patients’ outcomes.2

Responding to the Unmet Need

While the management landscape has changed over the years, patients with locally advanced or mUC still confront the wall of a 5-year mortality rate that has remained consistent overall in bladder cancer.2

However, diagnosing bladder cancers at earlier stages may correspond to a greater chance the patient has of surviving 5 years after diagnosis.2

Helping patients understand their personal risk factors can help them take a more active role in their health. For health care professionals, vigilant monitoring of symptoms and ensuring that management strategies are in place should receive greater emphasis going forward.

References: 1. National Cancer Institute. Urinary bladder (invasive & in situ) SEER 5-year relative survival rates, 2013-2019. https://seer.cancer.gov/statistics-network/explorer/application.html?site=71&data_type=4&graph_type=5&compareBy=stage&chk_stage_104=104&chk_stage_105=105&chk_stage_106=106&series=9&sex=1&race=1&age_range=1&advopt_precision=1&advopt_show_ci=on&hdn_view=1&advopt_show_apc=on&advopt_display=2#resultsRegion1. Accessed June 26, 2023. 2. National Cancer Institute. Cancer stat facts: bladder cancer. https://seer.cancer.gov/statfacts/html/urinb.html. Accessed May 24,2023. 3. National Cancer Institute. Urinary bladder (invasive & in situ) SEER relative survival rates by time since diagnosis, 2000-2019. https://seer.cancer.gov/statistics-network/explorer/application.html?site=71&data_type=4&graph_type=6&compareBy=stage&chk_stage_104=104&chk_stage_105=105&chk_stage_106=106&sex=1&race=1&age_range=1&advopt_precision=1&advopt_show_ci=on&hdn_view=0&advopt_display=2#graphArea. Accessed June 26, 2023. 4. Geynisman DM, Broughton E, Hao Y, et al. Real-world treatment patterns and clinical outcomes among patients with advanced urothelial carcinoma in the United States. Urol Oncol. 2022;40(5):195.e1–195.e11. doi:10.1016/j.urolonc.2021.11.014 5. American Cancer Society.Key statistics for bladder cancer. https://www.cancer.org/cancer/bladder-cancer/about/key-statistics.html. Updated January 13, 2023. Accessed January 30, 2023. 6. American Cancer Society. Bladder cancer risk factors. https://www.cancer.org/cancer/bladder-cancer/causes-risks-prevention/risk-factors.html. Updated January 30, 2019. Accessed October 13, 2023. 7. DeGeorge KC, Holt HR, Hodges SC. Bladder cancer: diagnosis and treatment. Am Fam Physician. 2017;96(8):507–514. 8. American Cancer Society. Bladder cancer early detection, diagnosis, and staging. https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/signs-and-symptoms.html. Updated January 30, 2019. Accessed August 9, 2023.