Bladder Ca in UK females rises 60% over 30 years

Shrewsbury, United Kingdom-Over the past 30 years, the incidence of bladder cancer has increased almost 60% among females in the United Kingdom. But this upward trend does not appear to be related to changes in smoking habits, as researchers from Royal Shrewsbury Hospital had previously thought.

In a previous report ("'Alarming rise' in female bladder cancer seen in UK," Urology Times, May 2002), the researchers said studies have shown women who smoke are more susceptible to bladder cancer than male smokers, and they are more likely to develop tumors. But the group's recent focused epidemiologic studies, published in this month's Journal of Urology (2004; 172:1051-55), demonstrated that the increased incidence may be due to other causes.

"As smoking is a known risk factor for bladder cancer, we looked at incidence rates for lung cancer, which are known to correspond closely with smoking rates, to identify a possible link between female smoking and the rising incidence," Dickon Hayne, MD, specialist registrar in urology at the hospital, told Urology Times.

Lower survival in women

By examining trends in bladder cancer incidence, mortality, and survival in England and Wales for the past three decades, Dr. Hayne and his team have shown that bladder cancer incidence has increased by 16% in males and 37% in females. Five-year relative survival for patients diagnosed between 1993 and 1995 was 67% for men but significantly worse-58%-in women.

Survival figures may not be comparable with U.S. data, as superficial noninvasive (pTa) tumors are excluded from the data.

"Interestingly, the pattern in the female cohort incidence of bladder cancer resembles the pattern for another malignancy-cervical cancer," Dr. Hayne said. "Smoking had previously been suggested as a major risk factor for cervical cancer, though ultimately, the predominant cause was shown to be the human papillomavirus.

"This raises at least the possibility that a sexually transmitted agent may now be playing a role in the development of bladder cancer in women. Clearly, further work is required to examine the causes for these trends," he said.