Nieder Alan M, Mackinnon Jill A, Huang Youjie, Fleming Lora E, Koniaris Leonidas G, Lee David J
Departments of Urology and Epidemiology and Preventive Health, University of Miami Miller School of Medicine, Miami, Florida, USA.
J Urol. 2008 Feb;179(2):491-5; discussion 495. doi: 10.1016/j.juro.2007.09.082.
There are no accepted screening recommendations for bladder cancer, although the greatest risk factors for bladder cancer are identifiable and modifiable, ie tobacco exposure. Bladder cancer survival correlates highly with disease stage. We ascertained whether there have been any demographic changes in the stage at presentation and mortality of bladder cancer in Florida during the last 25 years.
Data from Florida Cancer Data Registry were evaluated on all bladder cancer cases between 1981 and 2004. Cases were coded and analyzed as local, in situ or advanced (regional and distant) disease. Cases were stratified by demographic groups.
The overall incidence of bladder cancer decreased slightly in the last 25 years from 24.3 to 20.5 cases per 100,000 population. Overall white and Hispanic males had an almost 3 and 2-fold incidence of bladder cancer, respectively, compared to that in black males. White females had an almost 2-fold increased incidence compared to black and Hispanic females. Advanced stage bladder cancer decreased minimally in the 25 years. White and black females had the smallest decrease in the annual percent change of advanced bladder cancer. There was only a minimal decrease in bladder cancer mortality rates in black and white but not Hispanic individuals.
Despite knowledge of the main risk factors for bladder cancer there were only small decreases in the percent of patients presenting with advanced disease in Florida in the last 25 years. Thus, bladder cancer may be an appropriate cancer for increased public awareness campaigns and potentially targeted screening of high risk populations.
尽管膀胱癌的最大风险因素是可识别且可改变的，即烟草暴露，但目前尚无被广泛接受的膀胱癌筛查建议。膀胱癌的生存率与疾病分期高度相关。我们确定了佛罗里达州在过去25年中膀胱癌患者就诊时的分期及死亡率是否存在人口统计学变化。
对佛罗里达癌症数据登记处1981年至2004年间所有膀胱癌病例的数据进行评估。病例被编码并分析为局部、原位或晚期（区域和远处）疾病。病例按人口统计学分组进行分层。
在过去25年中，膀胱癌的总体发病率略有下降，从每10万人24.3例降至20.5例。总体而言，白人男性和西班牙裔男性的膀胱癌发病率分别是黑人男性的近3倍和2倍。白人女性的发病率比黑人和西班牙裔女性高出近2倍。晚期膀胱癌在这25年中下降幅度极小。白人女性和黑人女性晚期膀胱癌年变化率的下降幅度最小。黑人和白人的膀胱癌死亡率仅略有下降，但西班牙裔人群没有下降。
尽管了解膀胱癌的主要风险因素，但在过去25年中，佛罗里达州晚期膀胱癌患者的比例仅略有下降。因此，膀胱癌可能是开展提高公众意识活动以及对高危人群进行潜在针对性筛查的合适癌症类型。
