URINARY BLADDER CANCER

Based on the latest GLOBOCAN data, bladder cancer accounts for 5% of global cancer diagnoses and is especially prevalent in the developed world. In the United States, bladder cancer is the sixth most incident neoplasm. A total of 92% of bladder cancer diagnoses are made in those 55 years of age and older, and the disease is four times more common in men than women. While the average 7-year survival in the US is 80%, the 7-year survival for those with metastatic disease is a measly 4%. The strongest risk factor for bladder cancer is tobacco smoking, which accounts for 55–60% of all cases. Occupational or environmental toxins likewise greatly contribute to disease burden (accounting for an estimated 25% of all cases), though the precise proportion can be obscured by the fact bladder cancer develops decades after exposure, even if the exposure only lasted several years. Schistosomiasis infection is the common cause of bladder cancer in regions of Africa and the Middle East and is considered the second most onerous tropical pathogen after malaria. With 79% of cases attributable to known risk factors (and only 9% to heritable mutations), bladder cancer is a prime candidate for prevention strategies. Smoking cessation, workplace safety practices, weight loss, exercise and schistosomiasis prevention (via water disinfection and mass drug administration) have all been shown to significantly decrease the risk of bladder cancer, which poses a growing burden around the world.