Bladder cancer incidence statistics

Bladder cancer is the seventh most common cancer in the UK (2012), accounting for 3% of all new cases. In males, it is the fourth most common cancer (4% of all male cases), whilst it is the 13th most common cancer in females (2% of female cases).[1-4]

In 2012, there were 10,704 new cases of bladder cancer in the UK: 7,708 (72%) in men and 2,996 (28%) in women, giving a male:female ratio of around 25:10.[1-4] The crude incidence rate Open a glossary item shows that there are 25 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 Open a glossary item (AS rate) in males, is significantly higher in England compared with Scotland and Northern Ireland for males and is significantly higher in Wales compared with Northern Ireland.[1-4] Rates for females are similar across all the constituent countries of the UK.

Bladder Cancer (C67), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2012

England Wales Scotland Northern Ireland UK
Male Cases 6,621 393 559 135 7,708
Crude Rate 25.1 26.0 21.7 15.1 24.6
AS Rate 32.5 29.4 27.8 22.1 31.7
AS Rate - 95% LCL 31.7 26.5 25.5 18.4 31.0
AS Rate - 95% UCL 33.2 32.3 30.1 25.8 32.4
Female Cases 2,503 159 273 61 2,996
Crude Rate 9.2 10.2 10.0 6.6 9.2
AS Rate 9.4 9.4 9.9 7.4 9.4
AS Rate - 95% LCL 9.0 8.0 8.7 5.5 9.1
AS Rate - 95% UCL 9.8 10.9 11.1 9.2 9.7
Persons Cases 9,124 552 832 196 10,704
Crude Rate 17.1 18.0 15.7 10.7 16.8
AS Rate 19.4 18.3 17.3 13.6 19.0
AS Rate - 95% LCL 19.0 16.8 16.1 11.7 18.6
AS Rate - 95% UCL 19.8 19.8 18.5 15.5 19.4

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS Rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

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]

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  5. 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.
  6. National Cancer Intelligence Network (NCIN). Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
  7. National Cancer Intelligence Network (NCIN). Cancer e-Atlas. Accessed January 2014.
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Bladder cancer incidence is strongly related to age, with the highest incidence rates being in older men and women. In the UK between 2010 and 2012, an average of 54% of cases were diagnosed in men and women aged 75 and over, and 9 in 10 were diagnosed in those aged 60 and over.[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, peaking in males in the 90+ 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 at age 90+, 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 36:10.[1-4]

Bladder Cancer (C67), Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Population, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
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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.[1,2]

Bladder cancer incidence rates have decreased overall in Great Britain since the late-1970s, however this includes an increase until the early 1990s, followed by a decrease.[3-5] For males, European age-standardised (AS) incidence rates increased by 17% between 1979-1981 and 1992-1994, and have since decreased by 39%. The trend is similar for females, with rates increasing by 23% between 1979-1981 and 1992-1994, and since decreasing by 33%. 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.[6,7]

Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Over the last decade (between 2001-2003 and 2010-2012), the European AS incidence rates have decreased by 15% and 11% in males and females, respectively.[3-5,8]

Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Bladder cancer incidence rates have decreased overall for all of the broad age groups in males in Great Britain since the late-1970s, except for men aged 80+ in whom rates are now similar to the late-1970s.[3-5] For most age groups this period includes an increase until the 1990s, followed by a decrease. The largest increase during the 1970s and 1990s was in men aged 80+, in whom European AS incidence rates rose by 35% between 1977-1981 and 1993-1995. The largest decrease since the peak has been in men aged 50-59, with rates decreasing by more than double (166% decrease) between 1986-1988 and 2010-2012.

Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, Males, by Age, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Bladder cancer incidence rates have also decreased overall for all of the broad age groups in females in Great Britain since the late-1970s, except for women aged 80+ in whom rates are now higher.[3-5] Again for most age groups this period includes an increase until the 1990s, followed by a decrease. The largest increase was in women aged 80+, in whom European AS incidence rates rose by 39% between 1979-1981 and 1995-1997. The largest decrease since the peak has been in women aged 50-59, with rates falling by more than double (129% decrease) between 1984-1986 and 2010-2012.

Bladder Cancer (C67), European Age-Standardised Incidence Rates per 100,000 Population, Females, by Age, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. United Kingdom and Ireland Association of Cancer Registries. UKIACR Quality and Performance Indicators 2010.
  2. 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
  3. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  4. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  5. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  6. 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.
  7. Ferlay, J, Randi G, Bosetti C et al. Declining mortality from bladder cancer in Europe. BJU Int 2008;101(1):11-9
  8. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
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Staging completeness for bladder cancer is moderate in England, with 75% of bladder cancers recorded with a known stage at diagnosis in 2013.[1]

Bladder Cancer (C67), Proportion of Cases Diagnosed at Each Stage, England 2013

People diagnosed with bladder cancer with a known stage most commonly present at stage I (47%), in England. More people with a known stage are diagnosed at an early stage (74% diagnosed at stage I or II) than an advanced stage (26% diagnosed at stage III or IV). Around 1 in 5 (18%) people have metastases Open a glossary item at diagnosis (stage IV).[1]

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The lifetime risk of developing bladder cancer is 1 in 39 for men and around 1 in 110 for women, in 2012 in the UK.[1]

The lifetime risk for bladder cancer has been calculated to account for the possibility that someone can have more than one diagnosis of bladder cancer over the course of their lifetime (‘Adjusted for Multiple Primaries’ (AMP) method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. 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): p. 460-5.
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Bladder cancer is the 5th most common cancer in Europe, with more than 151,000 new cases diagnosed in 2012 (4% of the total). In Europe (2012), the highest World age-standardised incidence rates for bladder cancer are in Belgium for men and Hungary for women; the lowest rates are in the United Kingdom for men and the Ukraine for women. UK bladder cancer incidence rates are estimated to be the lowest in males in Europe, and 13th lowest in females.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

Bladder cancer is the 9th most common cancer worldwide, with around 429,800 new cases diagnosed in 2012 (3% of the total). Bladder cancer incidence rates are highest in Southern Europe and lowest in Western Africa, but this partly reflects varying data quality worldwide.[1]

Variation between countries may reflect difference prevalence of risk factors, use of screening, and diagnostic methods.

References

  1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed December 2013.
  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
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There is evidence for a small association between bladder cancer incidence and deprivation in the UK.[1-3] The most recent England-wide data for 2000-2004 show European age-standardised (AS) incidence rates are 20% higher for men living in the most deprived areas compared with the least deprived, and 35% higher for women.[1] 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.[1]

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.[2] 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.[3,4]

These results are not unexpected, as some bladder cancer risk factors - such as smoking – are generally more prevalent in more deprived populations.[5]

References

  1. National Cancer Intelligence Network (NCIN). Cancer Incidence by Deprivation, England 1995-2004. London: NCIN; 2008.
  2. Information Services Division (ISD) Scotland. Cancer Statistics. Cancer of the Bladder. Accessed September 2013
  3. Welsh Cancer Intelligence and Surveillance Unit. Cancer in Wales, 1995-2009: A Comprehensive Report. Cardiff: WCISU: 2011.
  4. Donnelly DW, Gavin AT, Comber H. Cancer in Ireland 1994-2004: A comprehensive report. Belfast: Northern Ireland Cancer Registry/National Cancer Registry, Ireland; 2009.
  5. Office for National Statistics (ONS). General lifestyle survey overview: A report on the 2011 general lifestyle survey. London: ONS:2013
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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.[1]

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.

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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.[1]

Bladder Cancer (C67), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 5,514 20,040 34,932
Female 1,913 6,453 11,608
Persons 7,427 26,493 46,540

Worldwide, it is estimated that there were nearly 1.2 million cancer patients still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence by Cancer Network, UK, 2006. London: NCIN; 2010.
  2. 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.
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