Bladder cancer is the ninth-most common malignancy in the world.35 There are 330,000 new cases and 130,000 deaths each year. In the United States alone there are over 63,000 new cases annually and 13,000 deaths.3
Smoking is the greatest risk factor and is estimated to be a causative factor in 65% of males and 30% females in some developed countries. Historically, some types of bladder cancer were associated with abuse of analgesic combinations containing phenacetin and occupational exposure in the aniline dye industry (e.g., exposure to 2-naphthylamine). In Egypt and some other African nations, chronic bladder infections with Shistosoma haematodium are a risk factor.
Bladder cancer is treated by surgical removal if disease is invasive. Superficial, localized cancers can be treated by local instillation of immunomodulatory agents (e.g., bacilli Calmette-Guerin [BCG]) or chemotherapy. Chemotherapy and/or radiation therapy have been used as an adjuant or neo-adjuant (before surgery) to cystectomy.
Five-year survival in the United States and other developed countries is over 90% for localized disease, 48% for regional disease, and 6% for metastatic disease.4 In developing countries, overall 5-year survival is o nly 30%-50% because detection and treatment are usually more delayed.
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