Bladder and Other Urothelial Cancers Screening (PDQ®)–Health Professional Version - National Cancer Institute

Bladder and Other Urothelial Cancers Screening (PDQ®)–Health Professional Version - National Cancer Institute

Bladder and Other Urothelial Cancers Screening (PDQ®)–Health Professional Version

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ON THIS PAGE

• Overview
• Description of the Evidence
• Changes to This Summary (08/12/2020)
• About This PDQ Summary

Overview

In This Section

• Benefits
• Harms

Note: Separate PDQ summaries on Bladder Cancer Treatment and Levels of Evidence for Cancer Screening and Prevention Studies are also available.

Benefits

There is inadequate evidence to determine whether screening for bladder and other urothelial cancers has an impact on mortality.

Description of the Evidence

• Study Design: There are no studies that directly address this question.
• Internal Validity: Not applicable (N/A).
• Consistency: N/A.
• Magnitude of Effects on Health Outcomes: N/A.
• External Validity: N/A.

Harms

Based on fair evidence, screening for bladder and other urothelial cancers would result in unnecessary diagnostic procedures with attendant morbidity.

Description of the Evidence

• Study Design: Opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.
• Internal Validity: N/A.
• Consistency: N/A.
• Magnitude of Effects on Health Outcomes: Good evidence for rare harms.
• External Validity: N/A.

Description of the Evidence

In This Section

• Incidence and Mortality
• Risk Factors
  • Smoking
  • Environmental and occupational exposure to certain chemicals
  • Chinese herbs
  • Exposure to arsenic
  • Treatment with cyclophosphamide or ifosfamide
  • Pelvic radiation therapy
  • Genetic mutations
  • Other risk factors
• Inheritance
• Clinical Presentation
• Histopathology
• Grade and Stage of Newly Diagnosed Bladder Cancer in an Unscreened Population
• Screening Methods
  • Cystoscopy and cytology
  • Hematuria
  • One-time hematuria testing
  • Repetitive hematuria testing
  • Other possible screening modalities
• Special Populations

Incidence and Mortality

Bladder cancer is the fourth most commonly diagnosed malignancy in men in the United States. The incidence is about four times higher in men than in women. It is estimated that 81,400 new cases of bladder cancer are expected to occur in the United States in 2020.[1]

Bladder cancer is diagnosed almost twice as often in whites as in blacks of either sex. The incidence of bladder cancer among other ethnic and racial groups in the United States falls between that of blacks and whites. The incidence of bladder cancer increases with age.[2]

Annual incidence rates of bladder cancer have been relatively stable from 1975 to 2017, ranging from 18.9 to 22.0 (per 100,000), although more recently (2008–2017) rates have been declining by about 1% per year.[3] It is estimated that 17,980 Americans will die of bladder cancer in 2020.[1]

Age-adjusted mortality from bladder cancer decreased in all races and sexes between 1975 and 2017.[3] From 2008 to 2017, urinary bladder cancer mortality decreased by 0.3% per year.[1] These changes may reflect earlier diagnosis, better therapy, less exposure to carcinogens, or some combination of these factors.

More than 90% of cancers in the bladder are transitional cell carcinomas (TCC), also called urothelial cancer. Urothelial cancer can also rarely develop in the lining of the renal pelvis, ureter, prostate, and urethra. Other important histologic types include squamous cell carcinoma (SCC) and adenocarcinoma. Adenocarcinomas account for less than 2% of primary bladder cancers, including metastases from the rectum, stomach, endometrium, breast, prostate, and ovary.[4]