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Eur J Cancer. 2018 May;95:52-58. doi: 10.1016/j.ejca.2018.03.001. Epub 2018 Apr 7.

Bladder cancer survival: Women better off in the long run.

Author information

1
Department of Research, Cancer Registry of Norway, PB 5313, Majorstuen, 0304, Oslo, Norway. Electronic address: b.k.andreassen@kreftregisteret.no.
2
Department of Research, Cancer Registry of Norway, PB 5313, Majorstuen, 0304, Oslo, Norway.
3
Department of Urology, Vestfold Hospital Trust, Tønsberg, Norway; Institute of Cancer Genetics and Informatics, Oslo University Hospital, Oslo, Norway.

Abstract

AIM:

Mortality among patients with bladder cancer is usually reported to be higher for women than men, but how the risk differs and why remain largely unexplained. We also described gender-specific differences in survival for patients with bladder cancer and estimated to what extent they can be explained by differences in T-stage distribution at the first diagnosis.

METHODS:

The present study comprised all 15,129 new cases of histologically verified invasive and non-invasive urothelial carcinoma of the urinary bladder diagnosed between 1997 and 2011 as registered in the Cancer Registry of Norway. Gender-specific excess mortality risk rates and risk ratios were calculated based on a flexible parametric relative survival model adjusting for T-stage and age, allowing the effect of gender to vary over time. We also present gender-specific relative survival curves for different T-stage patterns adjusted for age.

RESULTS:

Risk rates were significantly higher for women than men up to 2 years after bladder cancer diagnosis, particularly for muscle-invasive cancers. Thereafter, risk rates appeared to be higher in men. Adverse T-Stage distribution in women explained half of the unfavourable survival difference in female patients 2 years after diagnosis.

CONCLUSION:

The common view of worse bladder cancer prognosis in women than in men needs to be revised. Norwegian women have a less favourable prognosis solely within the first 2 years after diagnosis, particularly when diagnosed with a muscle-invasive tumour; parts of this discrepancy can be attributed to more severe initial diagnoses in women.

KEYWORDS:

Bladder cancer; Gender; Gender difference; Prognosis; Survival; Urothelial cancer

PMID:
29635144
DOI:
10.1016/j.ejca.2018.03.001
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