SEER data highlight lack of progress in bladder cancer control

Bladder cancer control outcomes have not improved in the United States within the last 30 years, according to a trend analysis presented by Firas Abdollah, MD.

Dr. Abdollah and colleagues determined age-adjusted incidence, 5-year cancer-specific survival, and mortality rates of bladder cancer in the U.S. for the years encompassing 1973 to 2006 using data obtained from the Surveillance, Epidemiology and End Results (SEER) database. The analyses included 136,339 patients diagnosed with histologically confirmed bladder cancer.

Temporal trends for the three outcome measures were quantified using the estimated annual percentage change, and the results for each endpoint were also calculated with patients stratified by disease stage (local, regional, distant, and unstaged).

The results showed the age-adjusted incidence rate was increased in the overall analysis and for local and distant-stage disease, while there was no change in the incidence of regional tumors, reported Dr. Abdollah, of Vita Salute San Raffaele University, Milan, Italy. The 5-year survival rate was also seen to increase over time in the overall analysis as well as in the stage-specific analyses for local, regional, and distant bladder cancer.However, while overall age-adjusted mortality rate decreased slightly over time, the shift was attributed to a drop in the mortality rate within the unstaged subgroup because the mortality rate was unchanged for localized and regional cancer and increased for distant-stage disease.

"Our study documented statistically significant changes in three direct outcome measures of bladder cancer. However, the changes are minor, clinically unimportant, and indicate there has been no improvement in bladder cancer detection or management during the last 30 years," Dr. Abdollah said.