Bladder Cancer: Pattern of Incidence in Iraq during 2022

Global Trends of Bladder Cancer Incidence and Mortality, and Their Associations with Tobacco Use and Gross Domestic Product Per Capita

PURPOSEPopulation-based cancer incidence rates of bladder cancer may be underestimated. Accurate estimates are needed for understanding the burden of bladder cancer in the United States. We developed and evaluated the feasibility of a machine learning–based classifier to identify bladder cancer cases missed by cancer registries, and estimated the rate of bladder cancer cases potentially missed.METHODSData were from population-based cohort of 37,940 bladder cancer cases 65 years of age and older in the SEER cancer registries linked with Medicare claims (2007-2013). Cases with other urologic cancers, abdominal cancers, and unrelated cancers were included as control groups. A cohort of cancer-free controls was also selected using the Medicare 5% random sample. We used five supervised machine learning methods: classification and regression trees, random forest, logic regression, support vector machines, and logistic regression, for predicting bladder cancer.RESULTSRegistry linkages yielded 37,940 bladder cancer cases and 766,303 cancer-free controls. Using health insurance claims, classification and regression trees distinguished bladder cancer cases from noncancer controls with very high accuracy (95%). Bacille Calmette-Guerin, cystectomy, and mitomycin were the most important predictors for identifying bladder cancer. From 2007 to 2013, we estimated that up to 3,300 bladder cancer cases in the United States may have been missed by the SEER registries. This would result in an average of 3.5% increase in the reported incidence rate.CONCLUSIONSEER cancer registries may potentially miss bladder cancer cases during routine reporting. These missed cases can be identified leveraging Medicare claims and data analytics, leading to more accurate estimates of bladder cancer incidence.

We evaluated prospectively the association between body mass index (BMI), height, recreational physical activity and the risk of bladder cancer among US adults. Data were used from 2 ongoing cohorts, the Health Professionals Follow-up Study and the Nurses' Health Study, with 3,542,012 years of follow-up and 866 incident bladder cancer cases (men = 507; women = 359) for the anthropometric analysis and 1,890,476 years of follow-up and 706 incident bladder cancer cases (men = 502; women = 204) for the physical activity analysis. Cox proportional hazard models were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI) between BMI, height, physical activity and bladder cancer risk adjusting for age, pack-years of cigarette smoking and current smoking. Estimates from each cohort were pooled using a random-effects model. We observed no association between baseline BMI and bladder cancer risk, even when we compared a BMI of > or =30 kg/m(2) to a BMI of 18-22.9 kg/m(2) [pooled multivariate (MV) RR, 1.16; 95% CI: 0.89-1.52]. A weak, but statistically significant, association was observed for the same comparison after excluding bladder cancer cases diagnosed within the first 4 years of follow-up (pooled MV RR, 1.33; 95% CI: 1.01-1.76). Height was not related to bladder cancer risk (pooled MV RR, 0.82; 95% CI: 0.65-1.03, top vs. bottom quintile). Total recreational physical activity also was not associated with the risk of bladder cancer (pooled MV RR, 0.97; 95% CI: 0.77-1.24, top vs. bottom quintile). Our findings do not support a role for BMI, height or physical activity in bladder carcinogenesis.

The preventive efficacy of the EGFr inhibitor Iressa was examined on the induction by OH-BBN of urinary bladder cancers in female Fischer-344 rats. The OH-BBN induced model yields invasive bladder tumors with most having the histopathological appearance of transitional cell carcinomas (TCC). The resulting tumors show various protein changes; e.g., increased expression of survivin, GSTPi, and various S100 calcium binding proteins that are routinely observed in human bladder cancers. More recent array data have also implied many similarities. Recently we examined the effects of daily treatment of rats with Iressa (6 mg/kg BW/day, i.g.) beginning either 2 weeks after the last dose of OH-BBN (24 weeks of treatment) or at 12 weeks after the last dose of OH-BBN when microscopic TCCs already existed (14- weeks of treatment). Both regimens decreased the incidence of large palpable bladder cancers by 90%. This demonstrated that Iressa was highly effective even when administered late in tumor progression. In contrast, treatment with Iressa beginning 2 weeks after the last OH-BBN and followed for only 14 weeks caused a 60% decrease in the incidence of microscopic bladder cancers. Additional data examining various dose levels and the combination of suboptimal doses of Iressa with NSAIDs will be presented. In addition, we examined biomarker modulation in OH-BBN bladder cancers treated short term (5 days) with Iressa. When using a candidate marker approach, it was found that Iressa decreased levels of EGFrP as expected, but caused striking decreases in levels of phosphorylated AKT as well. A more generalized approach to modulation of biomarkers was also taken to examine altered expression of peptides in Iressa treated and control bladder tumors employing 2D gel analysis. When certain of the identified peptides were examined by pathway analysis, it was found that certain proteins associated with the VEGF pathway [ANP32A and HNPRL] were both decreased in Iressa treated tumors. Supported by NCI Contract HHSN261200433001C. Citation Information: Mol Cancer Ther 2009;8(12 Suppl):C45.

To describe contemporary worldwide age-standardized incidence and mortality rates for bladder, kidney, prostate and testis cancer and their association with development. We obtained gender-specific, age-standardized incidence and mortality rates for 184 countries and 16 major world regions from the GLOBOCAN 2012 database. We compared the mortality-to-incidence ratios (MIRs) at national and regional levels in males and females, and assessed the association with socio-economic development using the 2014 United Nations Human Development Index (HDI). Age-standardized incidence rates were 2.9 (bladder) to 7.4 (testis) times higher for genitourinary malignancies in more developed countries compared with less developed countries. Age-standardized mortality rates were 1.5-2.2 times higher in more vs less developed countries for prostate, bladder and kidney cancer, with no variation in mortality rates observed in testis cancer. There was a strong inverse relationship between HDI and MIR in testis (regression coefficient 1.65, R2 = 0.78), prostate (regression coefficient -1.56, R2 = 0.85), kidney (regression coefficient -1.34, R2 = 0.74), and bladder cancer (regression coefficient -1.01, R2 = 0.80). While incidence and mortality rates for genitourinary cancers vary widely throughout the world, the MIR is highest in less developed countries for all four major genitourinary malignancies. Further research is needed to understand whether differences in comorbidities, exposures, time to diagnosis, access to healthcare, diagnostic techniques or treatment options explain the observed inequalities in genitourinary cancer outcomes.

Aim. To study the bladder cancer incidence in ethnic groups of the Republic of Kazakhstan.Methods. The study, covering the period from 2004 to 2013, included patients with newly diagnosed and registered cases of bladder cancer. Statistical methods of cancer incidence descriptive epidemiology were used. Besides, age-specific, crude and standardized indices of bladder cancer incidence were calculated.Results.In total in 10 years 4887 patients with bladder cancer were registered in Kazakhstan. Crude incidence rate of bladder cancer among the Kazakh ethnic group was the highest in Akmola (2.2) and Kostanay (2.2) regions, as well as in Almaty (2.1 per 100 thousand population). The lowest incidence rate among indigenous ethnic groups was registered in South Kazakhstan region - 0.8 per 100 thousand population. The highest average annual incidence of bladder cancer among Russians was registered in Almaty - 11.4 per 100 thousand population. The same high figures were registered in West Kazakhstan (11.0), North Kazakhstan (10.5), Kyzylorda (10.5) and Aktobe (10.0 per 100 thousand population) regions. The lowest incidence was observed among persons of Russian nationality in the Atyrau region (4.0 per 100 thousand population). In general, the incidence among the Kazakh ethnic group was 1.59±0.41 per 100 thousand, that was significantly less than among Russians - 8.25±1.88 per 100 thousand population (pConclusion. There is considerable ethnic variability in bladder cancer incidence in Kazakhstan: the incidence among Russians 5 times higher than among Kazakhs.

Gender Differences in Incidence, Diagnosis, Treatments, and Outcomes in Clinically Localized Bladder and Renal Cancer

577 Background: Bladder cancer is the most common type of genitourinary malignancy and is the fourth most common cancer in men in the US. Transitional cell carcinoma (TCC) of the bladder accounts for most bladder cancer cases. Previous studies have observed racial disparities in the prognosis between white and black populations with very little mentioned about other ethnicities and race groups that are part of the United States population. We hereby, present a detailed and comprehensive analysis of racial disparities in TCC survival in the US. Methods: Using the data from surveillance Epidemiology and End results (SEER) database, we identified patients with TCC between 1992 and 2015. We used multivariable covariate-adjusted Cox models to analyze the overall and TCC-specific survival of patients according to their race. Results: We evaluated 176,388 patients with TCC and after we adjusted for age, sex, race, stage, grade, and undergoing cancer-targeted surgery, we found that Asians/Pacific Islanders and Hispanics had a better overall survival when compared to whites (HR= 0.792, 95% CI [0.761-0.824], P<.001 and HR = 0.941, 95% CI [0.909-0.974], P = .001, respectively). Asians/Pacific Islanders also showed better TCC specific survival (HR = 0.843, 95% CI [0.759-0.894], P<.001). Blacks had worse overall survival and TCC-specific survival (HR =1.221, 95% CI [1.181-1.262], P <.001 and HR =1.325, 95% CI [1.268- 1.384], P <.001, respectively). When stage IV TCC was analyzed separately, only Hispanics showed better overall and TCC specific survival when compared to whites (HR = 0.896, 95% CI [0.806-0.997], P = 0.044 and HR = 0.891, 95% CI [0.797-0.996], P = 0.42). Conclusions: Asians/Pacific Islanders have better overall and TCC-specific outcome while blacks have the worst outcome compared to whites. Hispanics have better overall and cancer specific survival in stage IV TCC. These disparities likely related to different and complex factors from lifestyle and chemical exposure to genetic factors. Further studies can help us more in understanding and approaching this malignancy in different race groups.

MP35-09 MUNICIPAL DRINKING WATER CONSTITUENTS AND BLADDER CANCER INCIDENCE: A WATER-WIDE ASSOCIATION STUDY (WWAS)

Explore the unexplored: Potential anti-tumor properties of Rhododendron against bladder cancer.

Nutrition may impact bladder cancer survival. We examined the association between diet quality and overall and bladder cancer-specific survival. Bladder cancer cases from a population-based study reported pre-diagnosis diet. Diet quality was assessed using the 2010 Alternate Healthy Eating Index (AHEI-2010). Vital status was ascertained from the National Death Index. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using proportional hazards and competing risks regression models. Overall AHEI-2010 adherence was not associated with overall or bladder cancer-specific survival among non-muscle invasive bladder cancer (NMIBC) cases (HR, 1.00; 95% CI, 0.98-1.01; HR, 1.00; 95% CI, 0.97-1.02) or muscle invasive bladder cancer (MIBC) cases (HR, 0.99; 95% CI, 0.96-1.03; HR, 1.01, 95% CI 0.97-1.06). AHEI-2010 sugar-sweetened beverages adherence was associated with poorer overall survival (HR, 1.04; 95% CI, 1.01-1.08) and AHEI-2010 sodium adherence was associated with better overall and bladder cancer-specific survival after NMIBC diagnosis (HR, 0.92, 95% CI, 0.85-1.00; HR, 0.82; 95% CI, 0.68-0.98). AHEI-2010 fruit adherence was associated with poorer overall and bladder cancer-specific survival after MIBC diagnosis (HR, 1.17; 95% CI, 1.02-1.33; HR, 1.26; 95% CI, 1.03-1.55). Consumption of sugar-sweetened beverages, sodium, and fruit, not overall AHEI-2010 adherence, may be associated with bladder cancer survival.

Increased Incidence of Melanoma, Prostate, Lung, Bladder, Renal and Thyroid Cancer after Diagnosis of Primary Cutaneous B-Cell Lymphoma: A SEER Database Analysis

IntroductionThe aim of this article was to evaluate bladder cancer (BC) incidence, mortality and survival trends in Latvia over the past 28 years.Material and methodsOur study included patients diagnosed with BC between 1990 and 2017. The data were obtained from the national population-based cancer registry. Joinpoint regression analysis was used to identify points where a significant change in incidence and mortality trends occurred, accordingly with the patient’s gender and age. Relative survival (RS) was estimated by Ederer I and II methods.ResultsAltogether, 9589 patients with initial BC diagnosis were included in the study. The age-standardised (ASR) incidence rates (per 100,000) increased from 6.8 in 1990 to 12.5 in 2014 followed by a statistically insignificant decrease continuing up to 2017. The ASR BC mortality rates (per 100,000) also rose from 3.9 in 1990 to 4.4 in 2017. However, there was a decline in BC mortality trends in the age-group 40–59 with annual percentage change (APC) -1.1%. RS rates increased from 55.0 % in 1990–2000 to 59.0% in years 2013–2017.ConclusionsThis study revealed that the incidence and mortality rates have been gradually increasing over the past 28 years. The exception being cancer-specific mortality in the age group 40–59, which tends to decrease. Although the 5-year RS rates improved over the reviewed period, there is still plenty of room for improvement.

MAINTENANCE BACILLUS CALMETTE-GUERIN IMMUNOTHERAPY FOR RECURRENT TA, T1 AND CARCINOMA IN SITU TRANSITIONAL CELL CARCINOMA OF THE BLADDER: A RANDOMIZED SOUTHWEST ONCOLOGY GROUP STUDY

OBJECTIVETo investigate whether the risk of bladder cancer in individuals with newly diagnosed type 2 diabetes is influenced by the frequency of physician visits before diagnosis as a measure of detection bias.RESEARCH DESIGN AND METHODSWith the use of linked administrative databases from 1996 to 2006, we established a cohort of 185,100 adults from British Columbia, Canada, with incident type 2 diabetes matched one to one with nondiabetic individuals on age, sex, and index date. Incidence rates and adjusted hazard ratios (aHRs) for bladder cancer were calculated during annual time windows following the index date. Analyses were stratified by number of physician visits in the 2 years before diabetes diagnosis and adjusted for age, sex, year of cohort entry, and socioeconomic status.RESULTSThe study population was 54% men and had an average age of 60.7 ± 13.5 years; 1,171 new bladder cancers were diagnosed over a median follow-up of 4 years. In the first year after diabetes diagnosis, bladder cancer incidence in the diabetic cohort was 85.3 (95% CI 72.0–100.4) per 100,000 person-years and 66.1 (54.5–79.4) in the control cohort (aHR 1.30 [1.02–1.67], P = 0.03). This first-year increased bladder cancer risk was limited to those with the fewest physician visits 2 years before the index date (≤12 visits, aHR 2.14 [1.29–3.55], P = 0.003). After the first year, type 2 diabetes was not associated with bladder cancer.CONCLUSIONSThe results suggest that early detection bias may account for an overestimation in previously reported increased risks of bladder cancer associated with type 2 diabetes.