Bladder cancer incidence statistics
Incidence statistics for bladder cancer by country in the UK, age and trends over time are presented here. There are also data on lifetime risk, geography, socio-economic variation, ethnicity, and prevalence.
Find out more about the coding and counting of this data.
Bladder cancer is the seventh most common cancer in the UK (2011), accounting for 3% of all new cases. In males, it is the fourth most common cancer (4% of male total), whilst it is the 13th most common cancer in females (2% of female total).1-4
In 2011, there were 10,399 new cases of bladder cancer in the UK (Table 1.1): 7,452 (72%) in men and 2,947 (28%) in women, giving a male:female ratio of around 25:10.1-4 The crude incidence rate shows that there are 24 new bladder cancer cases for every 100,000 males in the UK, and 9 for every 100,000 females.
The European age-standardised incidence rate (AS rate) is significantly higher in England compared with Scotland and Northern Ireland for males (Table 1.1).1-4 Rates for females are similar across all the constituent countries of the UK.
Table 1.1: Bladder Cancer (C67), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2011
|AS Rate - 95% LCL||17.7||15.5||14.3||11.7||17.3|
|AS Rate - 95% UCL||18.6||18.9||16.9||16.2||18.1|
|AS Rate - 95% LCL||5.2||4.6||4.6||3.4||5.2|
|AS Rate - 95% UCL||5.6||6.3||6.0||5.6||5.6|
|AS Rate - 95% LCL||10.9||9.7||9.0||7.4||10.7|
|AS Rate - 95% UCL||11.3||11.5||10.4||9.8||11.1|
There was considerable geographical variation in bladder cancer incidence rates across the UK in the 1990s, with the highest rates within England being in Trent and the West Midlands, and the lowest in Eastern England.5 The latest analyses of bladder cancer incidence rates across the former cancer networks throughout the UK report significant variation, with higher than average rates within England in many parts of the north, and lower than average rates in parts of the south.6,7 Geographical differences in bladder cancer registration may partly explain these incidence patterns.5
section reviewed 16/04/14
section updated 16/04/14
Bladder cancer incidence is strongly related to age, with the highest incidence rates being in older men and women. In the UK between 2009 and 2011, an average of 53% of cases were diagnosed in men and women aged 75 and over, and nine in 10 were diagnosed in those aged 60 and over (Figure 1.1).1-4
Age-specific incidence rates rise gradually from around age 50-54 in both males and females, with a sharper rise in males from age 60-64, to peak in both sexes in the 85+ age group. Incidence rates are higher for males than for females in those aged 40 and over (the difference is not significant in younger age groups) and this gap is widest between the ages of 65 and 69, when the male:female incidence ratio of age-specific rates (to account for the different proportions of males to females in each age group) is around 37:10 (Figure 1.1).1-4
Figure 1.1: Bladder Cancer (C67), Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Population, UK, 2009-2011
section reviewed 16/04/14
section updated 16/04/14
Bladder cancer incidence trends should be interpreted with reference to changes in disease classification.
Since 2000, some cases which would previously have been classified as invasive carcinoma of the bladder (ICD-10 C67) are now coded as carcinoma in situ of the bladder (D09.0) or neoplasms of uncertain or unknown behaviour of the bladder (D41.4), meaning they are no longer included in the figures for bladder cancer as reported on this page. This change at least partly explains the observed fall in bladder cancer rates.8,9
Bladder cancer incidence rates have decreased overall in Great Britain since the mid-1970s, however this includes an increase until the early 1990s, followed by a decrease (Figure 1.2).1-3 For males, European AS incidence rates increased by 30% between 1975-1977 and 1992-1994, and have since decreased by 42%. The trend is similar for females, with rates increasing by 41% between 1975-1977 and 1991-1993, and since decreasing by 38%. There are likely to be several reasons for the recent decline, including the classification change described above. However, reductions in smoking and exposure to occupational carcinogens are also implicated; their role is evidenced by the decrease in mortality rates which is not explained by the classification change as this was not applied to mortality records.10,11
Figure 1.2: Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, Great Britain, 1975-2011
Bladder cancer incidence trends for the UK are shown in Figure 1.3.1-4 Over the last decade (between 2000-2002 and 2009-2011), the European AS incidence rates have decreased by 18% and 14% in males and females, respectively.
Figure 1.3: Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, UK, 1993-2011
Bladder cancer incidence rates have decreased overall for all of the broad age groups in males in Great Britain since the mid-1970s, except for men aged 80+ in whom rates are now higher (Figure 1.4).1-3 For most age groups this period includes an increase until the 1990s, followed by a decrease. The largest increase during the 1970s and 1980s was in men aged 85+, in whom European AS incidence rates rose by 69% between 1975-1977 and 1993-1995. The largest decrease since the peak has been in men aged 45-54, with rates decreasing by 65% between 1986-1988 and 2009-2011.
Figure 1.4: Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, Males, by Age, Great Britain, 1975-2011
Bladder cancer incidence rates have also decreased overall for all of the broad age groups in females in Great Britain since the mid-1970s, except for women aged 75 and above in whom rates are now higher (Figure 1.4).1-3 Again for most age groups this period includes an increase until the 1990s, followed by a decrease. The largest increase was in women aged 85+, in whom European AS incidence rates rose by 58% between 1975-1977 and 1997-1999. The largest decrease since the peak has been in women aged 45-54, with rates decreasing by 61% between 1986-1988 and 2009-2011.
Figure 1.5: Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, Females, by Age, Great Britain, 1975-2011
section reviewed 16/04/14
section updated 16/04/14
Lifetime risk is an estimation of the risk that a newborn child has of being diagnosed with cancer at some point during their life. It is a summary of risk in the population but genetic and lifestyle factors affect the risk of cancer and so the risk for every individual is different.
In 2010, in the UK, the lifetime risk of developing bladder cancer is 1 in 40 for men and 1 in 110 for women.12
The lifetime risk for bladder cancer has been calculated by the Statistical Information Team using the ‘Adjusted for Multiple Primaries’ (AMP) method; this accounts for the possibility that someone can have more than one diagnosis of bladder cancer over the course of their lifetime.13
section reviewed 24/04/13
section updated 24/04/13
An analysis of cancer incidence in the UK and Ireland highlighted considerable differences between cancer registries in the classification of bladder tumours which make the interpretation of any geographical patterns difficult.5 These differences in registration practice will also limit international comparisons.
The 2008 estimated age-standardised bladder cancer incidence rates reported for UK men are well below the EU average (18.5 v 27.4 per 100,000 population respectively) and the rate for women in the UK is slightly lower (5.1 v 5.6 per 100,000 population respectively) as Figure 1.6 shows.14
Figure 1.6: Bladder Cancer (C67), European Age-Standardised Incidence Rates, EU-27 Countries, 2008 Estimates
Worldwide an estimated 382,660 new cases of bladder cancer occur each year and, in terms of overall cancer frequency, it is ranked sixth.15 Figure 1.7 shows bladder cancer incidence rates worldwide.
Figure 1.7: Bladder Cancer (C67), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates
The highest bladder cancer incidence rates are generally found in industrially developed countries, particularly in North America and Southern and Western Europe, and in areas associated with endemic schistosomiasis16 in Africa and the Middle East.
Marked racial differences have been reported for bladder cancer incidence with higher rates in white than non-white populations. For example, in the USA, rates for white men are double those for black men: in 2000-2003 the age-adjusted incidence rate per 100,000 population was 40.2 for white males compared to 19.8 in black Americans. Bladder risk for US black women is about two-thirds that of US white women.17
These differences may be partly due to genes, as studies have shown that certain genetic polymorphisms linked to an increased risk of bladder cancer (for example, the NAT2 slow acetylator polymorphism) are much more prevalent in white than non-white populations.18
section reviewed 29/06/11
section updated 29/06/11
There is evidence for a small association between bladder cancer incidence and deprivation in the UK.20,23,24 The most recent England-wide data for 2000-2004 show European AS incidence rates are 20% higher for men living in the most deprived areas compared with the least deprived, and 35% higher for women.20 It has been estimated that there would have been around 900 fewer bladder cancer cases each year in England during 2000-2004 if all men and women had experienced the same rates as the most affluent.20
A study in Scotland for 2006-2010 showed that the gap in bladder cancer incidence by deprivation is slightly larger, with the most deprived people having 45% higher rates compared with the least deprived.23 A comparable association with deprivation has also been reported for women in Wales, but no significant association has been reported for men in Wales or for Northern Ireland.24,25
These results are not unexpected, as some bladder cancer risk factors - such as smoking – are generally more prevalent in more deprived populations.26
date reviewed 17/09/13
date updated 17/09/13
Age-standardised rates for White males with bladder cancer range from 19.9 to 20.5 per 100,000. Rates for Asian males are significantly lower, ranging from 6.5 to 10.1 per 100,000 and the rates for Black males are also significantly lower, ranging from 5.6 to 9.6 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 5.7 to 6.0 per 100,000, and rates for Asian and Black females are also significantly lower ranging from 1.3 to 2.7 per 100,000 and 1.6 to 3.7 per 100,000 respectively.27
Ranges are given because of the analysis methodology used to account for missing and unknown data. For bladder cancer, 42,339 cases were identified; 14% had no known ethnicity.
section reviewed 16/04/14
section updated 16/04/14
Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.
In the UK more than 46,500 people were still alive at the end of 2006, up to ten years after being diagnosed with bladder cancer (Table 1.2).22
Table 1.2: Bladder Cancer (C67), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006
|1 Year Prevalence||5 Year Prevalence||10 Year Prevalence|
Worldwide, it is estimated that there were nearly 1.2 million cancer patients still alive in 2008, up to five years after their diagnosis.15
section reviewed 17/05/13
section updated 17/05/13
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- Data were provided by the Office for National Statistics on request, July 2013. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
- Data were provided by ISD Scotland on request, May 2013. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
- Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, June 2013. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
- Data were provided by the Northern Ireland Cancer Registry on request, June 2013. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerData/OnlineStatistics/.
- Quinn M, Wood H, Cooper N, Rowan S, eds. Cancer Atlas of the United Kingdom and Ireland 1991–2000. Studies on Medical and Population Subjects No. 68. London: ONS; 2005.
- National Cancer Intelligence Network (NCIN). Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
- National Cancer Intelligence Network (NCIN). Cancer e-Atlas. Accessed January 2014.
- United Kingdom and Ireland Association of Cancer Registries. UKIACR Quality and Performance Indicators 2010. (PDF) 312 KB.
- Shah A, Rachet B, Mitry E, et al. Survival from bladder cancer in England and Wales up to 2001. Br J Cancer 2008; 99(S1):S86-9
- Pelucchi C, Bosetti C, Negri E, et al. Mechanisms of disease: The epidemiology of bladder cancer. Nat Clin Pract Urol 2006;3(6):327-40.
- Ferlay, J, Randi G, Bosetti C et al. Declining mortality from bladder cancer in Europe. BJU Int 2008;101(1):11-9
- Lifetime risk was calculated by the Statistical Information Team at Cancer Research UK, 2012.
- Sasieni PD, Shelton J, Ormiston-Smith N, et al. What is the lifetime risk of developing cancer?: The effect of adjusting for multiple primaries. Br J Cancer 2011;105(3):460-5.
- European age-standardised rates calculated by the Statistical Information Team at Cancer Research UK, 2011 using data from GLOBOCAN, IARC, version 1.2. http://globocan.iarc.fr.
- Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No.10 [Internet]. Lyon, France: International Agency for Research on Cancer (IARC): 2010. Available from http://globocan.iarc.fr. Accessed May 2011.
- World Health Organisation (WHO). Health Topics: Schistosomiasis. Accessed May 2011.
- Ries LAG, Harkins D, Krapcho M, et al (eds). SEER Cancer Statistics Review, 1975-2003. Bethesda, MD: National Cancer Institute; 2006.
- García-Closas M, Malats N, Silverman D, et al. NAT2 slow acetylation, GSTM1 null genotype, and risk of bladder cancer: results from the Spanish Bladder Cancer Study and meta-analyses. Lancet 2005;366(9486):649-59.
- Quinn M, Babb P, Brock A, Kirby L, Jones J. Cancer Trends in England & Wales, 1950-1999, SMPS No. 66. London: Office for National Statistics; 2001.
- National Cancer Intelligence Network (NCIN). Cancer Incidence by Deprivation, England 1995-2004. London: NCIN; 2008.
- National Cancer Intelligence Network (NCIN) and Cancer Research UK. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006. London: NCIN; 2009.
- National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence by Cancer Network, UK, 2006. London: NCIN; 2010.
- Information Services Division (ISD) Scotland. Cancer Statistics. Cancer of the Bladder. Accessed September 2013
- Welsh Cancer Intelligence and Surveillance Unit. Cancer in Wales, 1995-2009: A Comprehensive Report. Cardiff: WCISU: 2011.
- Donnelly DW, Gavin AT, Comber H. Cancer in Ireland 1994-2004: A comprehensive report. Belfast: Northern Ireland Cancer Registry/National Cancer Registry, Ireland; 2009.
- Office for National Statistics (ONS). General lifestyle survey overview: A report on the 2011 general lifestyle survey. London: ONS:2013
- National Cancer Intelligence Network and Cancer Research UK. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006. 2009