Global changes in bladder cancer mortality in the elderly |
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| Institution: | 1. Department of Surgery, Flinders University, Adelaide, Australia;2. Department of Urology, Austin Health, Melbourne, Australia;3. Urology Unit, Flinders Medical Centre, Adelaide, Australia;4. Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia;5. Discipline of Medicine, University of Adelaide, Adelaide, Australia;1. Belgian Cancer Registry, 1210 Brussels, Belgium;2. Family Medicine and Population Health, Department of Epidemiology and Social Medicine, University of Antwerp, 2000 Antwerp, Belgium;3. Centre for Cancer Detection, 8000 Bruges, Belgium;4. Vrije Universiteit Brussel, 1090 Brussels, Belgium;5. University Hospital Leuven, Campus Sint Rafael, 3000 Leuven, Belgium;6. Agency for Care and Health, Flemish Government, 1030 Brussels, Belgium;7. Christian Health Insurance Fund, 1031 Brussels, Belgium;8. Department of Public Health and Primary Care, Environment and Health, KU Leuven, 3000 Leuven, Belgium;9. Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands;1. Hereditary Cancer Program, Catalan Institute of Oncology-IDIBELL, ONCOBELL, Hospitalet de Llobregat, 08908 Barcelona, Spain;2. Biomedical Research Centre Network for Oncology (CIBERONC), Instituto Salud Carlos III, 28029 Madrid, Spain;3. Hereditary Cancer Program, Catalan Institute of Oncology, Badalona 08916, Barcelona, Spain;4. Department of Pathology, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;5. Department of Gastroenterology, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;6. Department of General Surgery, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;7. Colorectal Cancer Multidisciplinary Board, Catalan Institute of Oncology, Hospitalet de Llobregat, 08908 Barcelona, Spain;8. Colorectal Cancer Multidisciplinary Board, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain;9. Department of Medical Oncology, Catalan Institute of Oncology, Hospitalet de Llobregat, 08908 Barcelona, Spain;10. Bellvitge Health Sciences Campus, University of Barcelona, Hospitalet de Llobregat, 08908 Barcelona, Spain;11. Department of Radiation Oncology, Catalan Institute of Oncology, Hospitalet de Llobregat, 08908 Barcelona, Spain;12. Hereditary Cancer Program, Catalan Institute of Oncology-IDIBGI, OncoGir-Pro, 17007 Girona, Spain;1. Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark;2. Stanford Cancer Institute and Department of Medicine, Stanford University, Stanford, CA, USA;3. Stanford Center for Population Health Sciences and Department of Medicine, Stanford University, Stanford, CA, USA;4. Stanford Clinical Excellence Research Center, Stanford University, Stanford, CA, USA;1. Department of Gastroenterology, Mater Misericordiae University Hospital, Dublin, Ireland;2. School of Medicine, University College Dublin, Ireland;3. Centre for Colorectal Disease, St Vincent’s University Hospital, Dublin, Ireland;4. Department of Pathology, Mater Misericordiae University Hospital, Dublin, Ireland;5. Department of Pathology, St Vincent’s University Hospital, Dublin, Ireland;6. Department of Colorectal Surgery, St Vincent’s University Hospital, Dublin, Ireland;1. Max Planck Institute for Demographic Research, Rostock, Germany;2. School of Public Health, Chongqing Medical University, Chongqing, China;3. Department of Medical Sciences, University of Turin, Turin, Italy;4. Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland |
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| Abstract: | BackgroundBladder cancer is the 14th most common cause of cancer deaths worldwide and has a mean age of diagnosis of 73 years. Elderly people have fewer curative treatment options for muscle invasive bladder cancer. The aim of this study is to investigate how bladder cancer mortality has changed over the past forty years in different world regions to assess discrepancies between elderly and younger patients with bladder cancer.MethodsBladder cancer mortality data were extracted from the World Health Organisation’s GLOBOCAN database. Age-standardised mortality rates (ASMR) for bladder cancer were computed by year, sex, region and Human Development Index (HDI) using the world standard population.ResultsOverall ASMR in all available countries with data between 1986 and 2014 for men aged ≥ 75 has decreased from 101.2 to 89.9 per 100,000 (?11.2%). The decrease in ASMR for men < 75 has been 0.3–2.0 per 100,000 (?39.4%). In women aged ≥ 75 ASMR has decreased from 26.9 to 22.5 per 100,000 (?16.4%) and in women < 75 the ASMR has decreased from 0.76 to 0.56 per 100,000 (?26.4%).Correlation analysis showed a positive linear relationship between Human Development Index (HDI) and improvement in age-standardised mortality rate in all ages. Pearson’s coefficient showed that correlation was strongest in the 60–74 age group (r = ?0.61, p < 0.001) and weakest in those aged ≥ 75 (r = ?0.39, p = 0.01).ConclusionBladder cancer mortality is not improving in the elderly at the same rate as the rest of the population. Particular focus should be applied in future research to enhance and expand treatment options for bladder cancer that are appropriate for elderly patients. |
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| Keywords: | Bladder cancer Urothelial carcinoma Mortality Epidemiology Elderly |
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