Incidence Rates Of Bladder Cancer Research Articles

Clinical characteristics and molecular mechanisms underlying bladder cancer in individuals with spinal cord injury: a systematic review

BackgroundPatients with spinal cord injury have a relatively high risk for bladder cancer and often complicated with bladder cancer in advanced stages, and the degree of aggressiveness of malignancy is high. Most of the literature is based on disease clinical features while, our study reviews the clinical characteristics and molecular mechanisms of spinal cord injury patients with bladder cancer, so that it might help clinicians better recognize and manage these patients.MethodWe searched PubMed, Web of Science and Embase, using retrieval type like (“Neurogenic Lower Urinary Tract Dysfunction” OR “Spinal cord injury” OR “Spinal Cord Trauma”) AND (“bladder cancer” OR “bladder neoplasm” OR “bladder carcinoma” OR “Urinary Bladder Neoplasms” OR “Bladder Tumor”). In Web of Science, the retrieval type was searched as “Topic”, and in PubMed and Embase, as “All Field”. The methodological quality of eligible studies and their risk of bias were assessed using the Newcastle-Ottawa scale. This article is registered in PROSPERO with the CBD number: CRD42024508514.ResultIn WOS, we searched 219 related papers, in PubMed, 122 and in Embase, 363. Thus, a total of 254 articles were included after passing the screening, within a time range between 1960 and 2023. A comprehensive analysis of the data showed that the mortality and incidence rates of bladder cancer in spinal cord injury patients were higher than that of the general population, and the most frequent pathological type was squamous cell carcinoma. In parallel to long-term urinary tract infection and indwelling catheterization, the role of molecules such as NO, MiR 1949 and Rb 1. was found to be crucial pathogenetically.ConclusionThis review highlights the risk of bladder cancer in SCI patients, comprehensively addressing the clinical characteristics and related molecular mechanisms. However, given that there are few studies on the molecular mechanisms of bladder cancer in spinal cord injury, further research is needed to expand the understanding of the disease.

Abstract B001: Urinary bladder cancer incidence and mortality in the United States: 20-year trends and initial impact of the COVID-19 pandemic

Abstract Introduction: We examined nationwide trends in urinary bladder cancer incidence and mortality focusing on 1999-2019. A separate analysis of data from 2020 revealed how these rates were affected by the onset of the COVID-19 pandemic. Methods: State-specific bladder cancer (in situ and invasive) incidence and mortality rates were ascertained from the United States (US) Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database for 1999-2020 overall and according to age, gender, and geographic region. All rates were age-adjusted to the 2000 US Census population, except age-specific rates. We used Joinpoint software to calculate the 20-year average annual percent change and annual percent change for specific periods identified by data-driven joinpoint placement with 95% confidence intervals (CI). Results: In 2019, the US bladder cancer incidence rate was 18.8 (CI, 18.6 to 18.9) cases per 100,000. Bladder cancer incidence decreased 0.9% annually (CI, 0.8 to 1.0% decrease) during 1999-2019, with a 3.3% annual decrease (CI, 2.5 to 4.1% decrease) during 2016-2019 specifically. Among men, the 20-year annual decrease was 1.1% (CI, 1.0 to 1.1% decrease), with a 3.8% annual decrease (CI, 2.8 to 4.6% decrease) during 2017-2019 specifically. Among women, the 20-year annual decrease was 1.0% (CI, 0.9 to 1.2% decrease), with a 2.6% annual decrease (CI, 1.7 to 4.2% decrease) during 2016-2019 specifically. Largest annual decreases in incidence rates were seen among 55-59-year-olds (1.8%, CI, 1.6 to 2.0% decrease), and in the western US (2.3%, CI, 2.0 to 2.6% decrease). Conversely, some southern states showed an increase in incidence. In Tennessee, there was a 20-year annual increase of 1.2% (CI, 0.9 to 1.6% increase). In 2019, the US bladder cancer mortality rate was 4.1 (CI, 4.0 to 4.2) deaths per 100,000. Bladder cancer mortality decreased 0.4% annually (CI, 0.2 to 0.5% decrease) during 1999-2019, with a 2.5% annual decrease (CI, 1.3 to 4.7% decrease) during 2016-2019 specifically. Mortality rate trends were generally similar among men and women (0.4% and 0.7% decrease annually, respectively). Largest annual decreases in mortality rates were seen among 50-54-year-olds (1.5%, CI, 0.6 to 2.4% decrease) and in the northeast US (0.8%, CI, 0.7 to 1.0% decrease). Reflecting the initial impact of the COVID-19 pandemic, bladder cancer incidence decreased by 8.6% (CI, 7.7 to 9.6% decrease) and bladder cancer mortality decreased by 2.7% (CI, 0.6 to 4.8% decrease) comparing 2020 with 2019. Conclusions: After decades remaining relatively constant, bladder cancer incidence and mortality rates in the US began to decrease around 2016-2017. This trend was less apparent in the southern part of the country, where incidence trended upward in some states. As evident for other common cancers, bladder cancer incidence rates decreased sharply during the first year of the COVID-19 pandemic. Forthcoming data for 2021-2024 will provide a clearer picture of the magnitude of this disruption and the possibility of a rebound. Citation Format: Grace B. Gallant, Hugo Pomares-Millan, Judy R. Rees, Margaret R. Karagas, Michael N. Passarelli. Urinary bladder cancer incidence and mortality in the United States: 20-year trends and initial impact of the COVID-19 pandemic [abstract]. In: Proceedings of the AACR Special Conference on Bladder Cancer: Transforming the Field; 2024 May 17-20; Charlotte, NC. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(10_Suppl):Abstract nr B001.

Abstract 2199: Low-carbohydrate diet score and risk of bladder cancer: Findings from the Singapore Chinese Health Study

Abstract Background. Bladder cancer is a leading tumor of urinary tract with annually 570,000+ new cases and 200,000+ deaths worldwide. In the United States, the current incidence rate of bladder cancer is 15.8 per 100,000 population with more than 82,000 new cases and more than 16,000 deaths each year. Although smoking is established as a major risk factor for bladder cancer development, accounting for 30-50% cases, the role of other modifiable risk factors, including dietary in bladder cancer remains unclear. Low-carbohydrate diet (LCD) is a dietary pattern to restrict carbohydrate and to favor protein and/or fat intakes that has recently been well-accepted for weight loss. While its short-term effect to support the weight loss has been popular, its long-term effect on chronic diseases, including cancer, needs to be elucidated. In the current analysis, we sought to determine the association between LCD scores and bladder cancer risk in the Singapore Chinese Health Study (SCHS), an ongoing prospective cohort study consisting of more than 63,000 Chinese Singaporeans, 45- 74 years of age at baseline enrollment period 1995-1998. Methods. Total, animal-based and plant-based LCD scores were derived from the baseline dietary survey data, representing summed intake of carbohydrates, fats and proteins from all dietary, animal- and plant-food sources, respectively. Bladder cancer cases were ascertained using cancer registry. Cox proportional hazard regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for different LCD score levels with risk of bladder cancer. Results. By December 31, 2015, or after 17.6 years of follow-up, 250 bladder cancer cases were developed within the SCHS. Total LCD score was marginally associated with increased risk of bladder cancer (HRQ4vs.Q1=1.43, 95% CI: 0.98-2.09, Ptrend = 0.06). Animal-based LCD score was significantly associated with risk of bladder cancer. The HRs and respective 95% CIs of bladder cancer for quartiles 2, 3, and 4, compared with the lowest quartile, were 1.09 (0.76-1.56), 1.17 (0.81-1.70), and 1.53 (1.09-2.17) (Ptrend=0.01). The positive association was only present in men, ever smokers, never drinkers and individuals without history of type 2 diabetes (All P’sheterogeneity>0.05). Conclusions. In a prospective cohort study of more than 63,000 Chinese Singaporeans, we found that animal-based LCD score, representing a diet with lower carbohydrate and higher animal fat and protein, was significantly associated with increased risk of bladder cancer. Dietary modification is therefore suggested as an effective strategy for primary prevention of bladder cancer. Citation Format: Yen Thi-Hai Pham, Renwei Wang, Aizhen Jin, Woon-Puay Koh, Jian-Min Yuan, Hung N. Luu. Low-carbohydrate diet score and risk of bladder cancer: Findings from the Singapore Chinese Health Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2199.

Arab world's impact on bladder cancer research and opportunities for growth: A bibliometric review study.

Bladder Cancer (BC) is a widespread form of cancer that affects over 1.6 million people globally. The majority of cases are diagnosed as urothelial carcinoma, with a higher likelihood of diagnosis in men and with increasing age. The Arab world (AW) is one of the regions with the highest incidence and mortality rates of BC, and the average age of diagnosis is between 40 and 49 years in North Africa and the Middle East. This study aims to assess the activity and distribution of BC publications in the AW. A systematic search across MEDLINE and Embase databases spanning 2007 to 2021 identified 1208 English-language articles on bladder cancer with Arab affiliations. The dataset was normalized against the average population and GDP (2007-2020) for 22 Arab countries. Statistical analyses via SPSS and visualizations with VOSviewer unveiled collaboration patterns and thematic trends in Arab bladder cancer research. A total of 1208 BC publications were published in the AW, representing 0.24% of all biomedical publications. Egypt topped the list with the highest number of publications. The co-authorship analysis generated by VOSviewer revealed that out of 4766 authors, 161 met the minimum threshold of 5 publications. The findings reveal that Egypt and Jordan are at the forefront of BC research in the region, while other Arab countries are lagging behind despite being heavily impacted by the disease. To drive progress in the field, it's important to uncover the obstacles impeding BC research in these countries and implement effective solutions to overcome them.

Longitudinal Analysis of Bladder Cancer-Specific Mortality Trends in the United States.

Bladder cancer is the tenth leading cause of cancer death in the United States (US). Advances in diagnosis, imaging, and treatments have led to improvements in bladder cancer management. To evaluate longitudinal bladder cancer mortality trends from 1999-2020 in the US by gender, race, ethnicity, age, geographic region, and urbanization category. Age-adjusted bladder cancer death and incidence rates of individuals in the US of all ages between 1999-2020 were obtained using the CDC WONDER and NAACCR databases. Trends and average annual percent changes (AAPC) in age-adjusted Bladder Cancer-Specific Mortality (BCSM) and incidence rates were estimated. Data were analyzed from May 2023 to October 2023. From 1999-2020, overall BCSM decreased by 0.4% annually, with a dramatic decrease in deaths between 2015-2020 (AAPC: -2.0% [95% CI: -2.6,-1.3]). However, BCSM rates and metastatic malignant bladder cancer incidence rates from 1999-2020 increased for individuals≥85 years old (AAPC for BCSM: 0.8% [95% CI:0.5,1.1]; AAPC for metastatic malignant incidence: 2.5% [95% CI: 2.0,2.9]). Increases in BCSM were found for certain years in the South, in rural areas, and for Non-Hispanic White and Asian or Pacific Islander individuals. Overall mortality from bladder cancer has been decreasing in the US over two decades. Upon disaggregation, increasing trends were found for BCSM and for metastatic malignant bladder cancer incidence for individuals≥85 years old from 1999-2020. Further evaluation of these trends is essential to understand how to target specific populations to improve patient outcomes.

Cost of bladder cancer in Lebanon before and after the economic collapse: a probabilistic modeling study

Background and objectivesLebanon has one of the highest incidence rates of bladder cancer (BC) in the world. In 2019, Lebanon’s economy collapsed which majorly impacted healthcare costs and coverage. This study assesses the overall direct costs of urothelial BC in Lebanon, from the perspective of public and private third-party payers (TPP) and households, and evaluates the impact of the economic collapse on these costs.MethodsThis was a quantitative, incidence-based cost-of-illness study, conducted using a macro-costing approach. Costs of medical procedures were obtained from the records of various TPPs and the Ministry of Public Health. We modeled the clinical management processes for each stage of BC, and conducted probabilistic sensitivity analyses to estimate and compare the cost of each stage, pre-and post-collapse, and for each payer category.ResultsBefore the collapse, the total annual cost of BC in Lebanon was estimated at LBP 19,676,494,000 (USD 13,117,662). Post-collapse, the total annual cost of BC in Lebanon increased by 768% and was estimated at LBP 170,727,187,000 (USD 7,422,921). TPP payments increased by 61% whereas out-of-pocket (OOP) payments increased by 2,745% resulting in a decrease in TPP coverage to only 17% of total costs.ConclusionOur study shows that BC in Lebanon constitutes a significant economic burden costing 0.32% of total health expenditures. The economic collapse induced an increase of 768% in the total annual cost, and a catastrophic increase in OOP payments.

Temporal Trends and Projections of Bladder Cancer Burden in China from 1990 to 2030: Findings from the Global Burden of Disease Study.

Identifying disease burden and risk factors of bladder cancer and projecting its epidemiological trend in China, which can provide reference data to formulate measures for its management and prevention. We analyzed the incidence, mortality, and disability-adjusted life-years (DALYs) data of bladder cancer in China from 1990 to 2019 and predicted to 2030 based on the Global Burden of Disease Study 2019. We also estimated the proportion of risk factors contributing to bladder cancer DALYs. The average annual percentage change (AAPC) in both sexes was calculated to quantify the temporal trends. In China, the age-standardized incidence rate of bladder cancer increased from 3.3/100,000 in 1990 to 5.16/100,000 in 2019 (AAPC of 1.47), while the age-standardized mortality rate and age-standardized DALYs rate declined slightly (AAPC of -0.58 and -0.65, respectively). The burden of bladder cancer increased with age, which reached a peak over 85 years old. The main risk factor for bladder cancer was smoking, and the contribution of high fasting plasma glucose increased from 1990 to 2019, with an AAPC of 0.85 in males and 0.61 in females. We predicted total incident cases, deaths and DALYs will increase to 150,372 and 53,520 and 1043,688 in 2030, respectively. The disease burden of bladder cancer in males will consistently higher than that in females from 2020 to 2030. Although mortality and DALYs rates showed downward trends, the disease burden remained heavy in China at present. More effective and long-term health policies are needed to develop for early prevention and treatment of bladder cancer.

Abstract 3771: Mitochondrial metabolism and racial disparity of bladder cancer

Abstract Potential differences and mechanism in metabolism among bladder cancer (BLCA) patients of diverse race or ethnicities remain largely unexplored. Even though the incidence rate of BLCA in African Americans (AA) is nearly half as that of European Americans (EA), but AA have the worst survival. We performed the transcriptomics and metabolomics profiling in ancestry verified patients from AA and EA BLCA and observed mitochondrial complex activities were uniquely enriched in AA tumors compared to EA tumors. In addition, in vitro assay demonstrated differences in mitochondrial complex protein and activity between AA and EA BLCA. We further confirmed the reprogramming of mitochondrial metabolism using in vitro 13C labeled tracers in both AA and EA BLCA. Integration of metabolomics and transcriptomics data reveals the enrichment of mTOR pathway in AA BLCA. Our findings indicate that an elevated mitochondrial oxphos activity through mTOR activation could be a factor for AA BLCA progression and provide the rationale to examine mitochondrial specific inhibitors along with mTOR inhibitors to target BLCA on subset of patients from the AA community. Citation Format: Karthik Reddy Kami Reddy, Jun Hyoung Park, Roni J. Bollag, Allison Bellman, Martha Terris, Seth P. Lerner, Leomar Y. Ballester, Yair Lotan, Benny Abraham Kaipparettu, Nagireddy Putluri. Mitochondrial metabolism and racial disparity of bladder cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3771.

Machine Learning Methods to Identify Missed Cases of Bladder Cancer in Population-Based Registries.

PURPOSEPopulation-based cancer incidence rates of bladder cancer may be underestimated. Accurate estimates are needed for understanding the burden of bladder cancer in the United States. We developed and evaluated the feasibility of a machine learning–based classifier to identify bladder cancer cases missed by cancer registries, and estimated the rate of bladder cancer cases potentially missed.METHODSData were from population-based cohort of 37,940 bladder cancer cases 65 years of age and older in the SEER cancer registries linked with Medicare claims (2007-2013). Cases with other urologic cancers, abdominal cancers, and unrelated cancers were included as control groups. A cohort of cancer-free controls was also selected using the Medicare 5% random sample. We used five supervised machine learning methods: classification and regression trees, random forest, logic regression, support vector machines, and logistic regression, for predicting bladder cancer.RESULTSRegistry linkages yielded 37,940 bladder cancer cases and 766,303 cancer-free controls. Using health insurance claims, classification and regression trees distinguished bladder cancer cases from noncancer controls with very high accuracy (95%). Bacille Calmette-Guerin, cystectomy, and mitomycin were the most important predictors for identifying bladder cancer. From 2007 to 2013, we estimated that up to 3,300 bladder cancer cases in the United States may have been missed by the SEER registries. This would result in an average of 3.5% increase in the reported incidence rate.CONCLUSIONSEER cancer registries may potentially miss bladder cancer cases during routine reporting. These missed cases can be identified leveraging Medicare claims and data analytics, leading to more accurate estimates of bladder cancer incidence.

Incidence trends in lung and bladder cancers in the Nordic Countries before and after the smoking epidemic.

Cigarette smoking epidemic, which started before the World War II, completely changed the cancer landscape. Reliable incidence data spanning the stepwise spreading epidemic are rare, but the Nordic cancer registries are unique sources in being able to catch the pre-epidemic situation in the female population where smoking became more prevalent after the War. For Swedish men, smoking prevalence has decease early and cancer rates may herald postsmoking rates. We used data from the NORDCAN database, constructed by the cancer registries of Denmark, Finland, Norway and Sweden, for the analysis of incidence changes in lung and bladder cancers from year 1943 (Denmark), from 1953 (Finland and Norway) and from 1960 (Sweden) until year 2016. The analyses revealed four novel observation relevant to the smoking epidemic. (1) The incidence of lung cancer in Norwegian women in the 1950s, when the smoking prevalence was very low, was 1.8/100 000 (world standard rate), which is at the level of lowest global female rates known to-date; (2) the earliest lung-to-bladder incidence ratio among Norwegian women was 0.64, probably benchmarking the incidence rates prior to the smoking epidemic; (3) bladder cancer incidence for Finnish women diagnosed in the 1950s was 1.2/100 000 which is at the level of the lowest rates currently known and (4) Swedish men with the lowest smoking prevalence in Europe, showed an epochal crossing of lung and bladder cancer incidence rates before year 2015. The data suggest that the approaching of the incidence rates for lung and bladder cancer can be expected in the course of the abating smoking epidemic.

Ensemble forecasting of a continuously decreasing trend in bladder cancer incidence in Taiwan

Bladder cancer is one of the most common malignancies involving the urinary system of about 1.65 million cases worldwide. To attain the 25 by 25 goal set by the World Health Organization (25% reduction in non-communicable diseases between 2015 and 2025), developing strategies to reduce cancer burdens is essential. The data of the study comprised the age-specific bladder cancer cases and total population numbers from age 25 to 85 and above from 1997 to 2016 in Taiwan. An ensemble age–period–cohort model was used to estimate bladder cancer incidence trends and forecast the trends to 2025. For men, the projected age-standardized incidence rates per 100,000 people in 2020 and 2025 are 13.0 and 10.4, respectively, with a 16.1% and 32.9% decrease projected from 2016 to 2020 and 2025, respectively. For women, the projected age-standardized incidence rates per 100,000 people in 2020 and 2025 are 4.7 and 3.7, respectively, with a 16.1% and 33.9% decrease projected from 2016 to 2020 and 2025, respectively. The age-specific bladder cancer incidence rates demonstrated a consistently downward trend after 2003 for all ages and both sexes. This study projects that the incidence rates of bladder cancer in Taiwan will continue to decrease, and more than a 25% reduction can be achieved from 2016 to 2025.

Bladder Cancer Incidence and Survival in the United States and Texas Non-Latino Whites and Latinos

BACKGROUND: Bladder cancer (BC) poses an enormous burden on health care systems. Latinos in Texas (TX) were underrepresented in previous studies on racial/ethnic disparity of BC in the US. OBJECTIVE: To examine whether BC incidence and survival rates differ among Latinos compared to non-Latino whites (NLW) in South TX, TX, and the US SEER. METHODS: Data was collected from the US SEER Program and the Texas Cancer Registry. Annual age-specific and age-adjusted BC incidence rates and annual 5-year relative survival were calculated. RESULTS: South TX and TX had significantly lower BC incidence rates than SEER for both Latinos and NLW regardless of gender (Ps < 0.05). South TX women had worse BC survival rates than SEER women for both Latinos and NLW (Ps < 0.05). TX NLW had worse BC survival rates than SEER NLW for both genders together and men only (Ps < 0.05). All Latino groups had lower incidence but worse survival rates than NLW groups for both men and women in each geographic area (all Ps < 0.05). Women had significantly lower BC incidence but worse survival rates than men regardless of race/ethnicity in each geographic area (all Ps < 0.05). CONCLUSIONS: South TX women had lower BC incidence but worse survival rates than US SEER women for both Latinos and NLW. Latinos had worse survival but lower incidence rates than NLW. Women had lower BC incidence but worse survival rates than men. The study identifies the BC distribution and high-risk population, racial/ethnic disparities, and geographic differences. It facilitates health care services planning.

25-Year Trends in Stage-Specific Incidence Rates for Bladder Cancer in a Large Statewide Registry

BACKGROUND: Bladder cancer (BC) is a common genitourinary malignancy with over 80,000 new cases diagnosed annually and over 17,000 associated deaths. OBJECTIVE: We review 25-years of BC incidence (1993-2017) within the state of Pennsylvania to better define incidence, geographic distribution, and trends over time. METHODS: The Pennsylvania Cancer Registry was reviewed for statewide and component county age-adjusted BC incidence rates and stage distribution. Chloropleth maps plotting statewide and county-specific incidence rates across time were created using the GeoDa statistical package. RESULTS: 93,476 cases of BC were recorded in Pennsylvania from 1993 to 2017. Age-adjusted annual rates of BC over the study interval were stable at 24.5 patients per 100,000 (range, 22.7–25.6). However, annual rates of distant disease increased from 0.5 to 1.1 patients per 100,000 (p < 0.001) with an average percent change increase of 6.6% over the study interval. The annual percent distribution of distant disease doubled from 2.3% to 5.1% (p < 0.001) with a greater increase in women compared to men. Chloropleth maps highlighted growing “hot spots” of bladder cancer incidence in the northwestern, northeastern, and southeastern portions of the state. CONCLUSIONS: While BC incidence in the state of Pennsylvania has remained relatively stable over the past 25 years, a concerning increase in distant disease was observed. Geospatial investigation implicates higher risk regions. Further studies are necessary to delineate the underlying etiologies for these observations.

Abstract 4501: RNA seq analysis reveals altered immune specific gene signature in African American bladder cancer

Abstract Understanding specific functional gene signature among bladder cancer (BLCA) patients of diverse race/ethnicities remain largely unexplored. Even though the incidence rate of BLCA in African Americans (AA) is nearly half as that of European Americans (EA), but AA have the worst survival. This survival difference can be attributed to unequal access to health care, and social economic status, which in turn delays the treatment in AA patients. Here, we analyzed RNA-seq data from AA and EA patient cohort compare with adjacent benign tissues and identified a set of signature genes which are significantly altered in AA patients. Gene Set Enrichment Analysis (GSEA) reveals that these genes are significantly enriched in immune pathways. Several known cytokines, cell differentiated markers and transcription factors including, growth differentiation marker 2 (GDF2), Carcinoembryonic Antigen Related Cell Adhesion Molecule 1 (CEACAM1), Cytotoxic T-Lymphocyte Associated Protein 4 (CTLA4) were downregulated and fibroblast growth factor 1 (FGF1), Caudal type homeobox 1 (CDX1) were upregulated in AA compare to EA. To interrogate the function of specific genes in tumor, we have used an integrated repository portal for tumor-immune system interactions (TISIDB). Using this disease association analysis, we identified a common relationship of these genes with immune response, cytokine signaling and regulation of lymphocyte activation. Our findings indicate that an altered tumor-immune interplay could be a factor for AA BLCA progression and provide the rationale to examine immune specific checkpoint inhibitors to target BLCA on subset of patients from the AA community. Key words: Racial disparity, Immune system, Bladder cancer. Citation Format: Karthik reddy kami reddy, Balasubramanyam Karanam, Cristian Coarfa, Yair Lotan, Roni J. Bollag, Martha K. Terris, Nagireddy Putluri. RNA seq analysis reveals altered immune specific gene signature in African American bladder cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4501.

Bladder cancer incidence rates and trends in young adults aged 20-39 years

ObjectivesTo assess contemporary gender, race and stage-specific incidence and trends of bladder cancer among young adults in the United States. Materials and methodsWithin Surveillance, Epidemiology, and End Results database (2001–2016), all patients aged 20 to 39 years-old with histologically confirmed bladder cancer were included. Age-standardized rates (ASR per 100,000 person-years) were estimated. Temporal trends were calculated through joinpoint regression analyses to describe the average annual percent change (AAPC). ResultsFrom 2000 to 2016, 2,772 new cases were recorded (ASR 0.2, AAPC -1.5%, P = 0.01). ASRs were higher in males than in females (0.3 and 0.1, respectively) and decreased significantly in both genders (AAPC -1.3, P = 0.02 and -2.2% P = 0.03, respectively). non-Hispanic White (NHW) accounted for 70.7% of the cohort and had the highest incidence (ASR 0.3) that decreased over time (AAPC -1.4%, P = 0.02). Conversely, ASRs in other ethnic groups were lower and showed stable trends. The most frequent tumor characteristics were Ta/TisN0M0 stage (71.0%, ASR 0.1, AAPC -1.0%, P = 0.1), low grade (61.6%, ASR 0.1, AAPC -4.3%, P = 0.001) and urothelial histology (95.5%, ASR 0.2, AAPC -1.5%, P = 0.01). ConclusionsDespite the rarity of bladder cancer in those aged 20 to 39 years, a standard work-up is required to avoid advanced stage at diagnosis. The current data validate initial diagnoses at earliest stage in the vast majority of young adults. Moreover, decreasing ASRs in both genders are encouraging.

Temporal trends of bladder cancer incidence and mortality from 1990 to 2016 and projections to 2030.

BackgroundBladder cancer is a leading cause of cancer-related deaths all over the world. Epidemiological studies of bladder cancer are therefore crucial for policy making. This study was carried out to describe the characteristics of changes in the incidence and mortality of bladder cancer from 1990 to 2016 by age group, gender, geographical region, and sociodemographic index (SDI) and to simultaneously project future trends up to 2030.MethodsIncidence and mortality trends in bladder cancer from 1990 to 2016 were described based on data and methodologies from the Global Burden of Disease (GBD) Study. The data also allowed the future trends of bladder cancer incidence and mortality to be predicted by ARIMA model. Trends were analyzed by age group, gender, and SDI. Projections to 2030 were sub-analyzed by SDI countries. R software (x64 version 3.5.1), SAS (version 9.3), and SPSS (version 22.0) were used throughout the process.ResultsGlobally, in 2016, there were 437,442 [95% uncertainty interval (UI), 426,709–447,912] new bladder cancer cases and 186,199 (95% UI, 180,453–191,686) bladder cancer-associated deaths. Between 1990 and 2016, changes in the age-standardized incidence rate (ASIR) of bladder cancer decreased by 5.91% from 7.11 (95% UI, 6.93–7.27) in 1990 to 6.69 (95% UI, 6.52–6.85) in 2016. The age-standardized death rate (ASDR) decreased from 3.58 (95% UI, 3.49–3.68) to 2.94 (95% UI, 2.85–3.03) over the same period of time. In future, the greatest occurrence of bladder cancer will be in high SDI countries, followed by high-middle SDI countries. Moreover, bladder cancer incidence rates may increase substantially in middle SDI countries, while the incidence rates will remain relatively stable for men and women in other SDI countries. From 2017 to 2030, bladder cancer deaths will continue to increase in low SDI countries, while deaths in other SDI countries will continue to decrease.ConclusionsThere was a regional difference in the incidence and mortality trends of bladder cancer between 1990 and 2016. Overall, the situation is not optimistic. From 2017 to 2030, the incidence of bladder cancer will continue to rise, especially in high and high-middle SDI countries, where decision-makers should propose appropriate policies on the screening and prevention of bladder cancer.

Bladder Cancer in Iran: An Epidemiological Review.

PurposeBladder cancer is the sixth most common cancer in Iran. Information about the epidemiological situation of the disease and its risk factors is necessary for conducting a planning program to reduce the disease. This study is conducted with the aim of evaluating the epidemiological features of bladder cancer in Iran.MethodsThis is a systematic review of the published articles in both Persian and English in international and national journals during the years 2000–2019 with key words of Iran and bladder cancer. Articles were selected from the national information database (SID, Magiran) and international databases (PubMed, Scopus, and Web of Science). Articles related to the epidemiological aspects of the disease, including incidence, prevalence, mortality, and risk factors, were evaluated.ResultsThe incidence rate of bladder cancer was about 1.6–115; cumulative survival rate was 0.95, mortality rate was 0.5–0.84 and its prevalence in the Iranian population was between 4.10% and 12.8%. The risk of developing malignancy in major risk factor groups, including smoking and opium, was 6.2 (2.04–18.7), increases in protein and animal fat consumption were about 5- and 19-times higher than in the general population, respectively. In terms of occupational exposure, bus and heavy truck drivers were 11.3 (1.3–92.05) more at risk than others.ConclusionRegarding the increasing trend of this disease, changes in lifestyle to reduce risk factors can be effective in decreasing the incidence and mortality rate of this malignancy.

Reduction in the Incidence of Urological Cancers after the Ban on Chinese Herbal Products Containing Aristolochic Acid: An Interrupted Time-Series Analysis

Cancer is a public health problem worldwide. Taiwan has a higher incidence rate of urological cancers than many Asian countries do. Aristolochic acid has been considered a potent carcinogen. In this study, we examined whether the cessation of the sales and preparation of aristolochic acid-containing Chinese herbal products (AA-CHPs) in Taiwan contributed to a decline in the incidence rates of bladder cancer, carcinomas of the renal pelvis and other urinary organs, and kidney cancer. We conducted an interrupted time-series analysis of long-term trends in the incidence rates of the aforementioned cancers between 1995 and 2013 in Taiwan. The incidence rates of bladder cancer and carcinomas of the renal pelvis and other urinary organs decreased considerably after 2008 and 2011, respectively. Notably, these change-of-slope time points occurred after the year 2003, when a ban on AA-CHPs was imposed in Taiwan. The ban on AA-CHPs in Taiwan was possibly associated with the reduction in the incidence of bladder cancer and carcinomas of the renal pelvis and other urinary organs.

Post-authorisation Safety Study of Pioglitazone Use and Safety Endpoints of Interest in Denmark After Direct Healthcare Professional Communication.

IntroductionA Direct Healthcare Professional Communication (DHPC) sent in Denmark on 11 August 2011 provided information on new pioglitazone labelling and guidance on monitoring treatment effectiveness. We describe pioglitazone use in Denmark after the DHPC, estimate the incidence of heart failure (HF), quantify pioglitazone cessation following a diagnosis of bladder cancer (BC) or uninvestigated macroscopic haematuria, and describe glycated haemoglobin (HbA1c) values.MethodsThis was a cohort study. From Danish population-based registries, cohorts of type 2 diabetes mellitus incident or prevalent users of pioglitazone or insulin in 2011–2015 were created. Patient characteristics, treatment patterns, laboratory results (available for a regional subset of the population), and incidence rates of HF and BC were estimated.ResultsThere were 80 pioglitazone and 17,699 insulin incident users, 140 pioglitazone and 13,183 insulin prevalent users. There were no new BC cases among incident pioglitazone users, and < 5 new BC cases among prevalent pioglitazone users. Pioglitazone was rarely the first-line treatment. History of haematuria was documented in < 5 incident and 11 prevalent pioglitazone users. During follow-up, there were < 5 HF cases among 77 incident pioglitazone users and < 5 among 133 prevalent pioglitazone users without a history of HF. Median HbA1c at index date was 7.8% and 8.8% in incident pioglitazone and insulin cohorts, and 7.5% and 7.6% in prevalent pioglitazone and insulin cohorts, respectively. During follow-up of up to 4.4 years, 28.8% incident and 20.7% prevalent pioglitazone users discontinued pioglitazone.ConclusionsNumbers of pioglitazone users in Denmark were low and decreased over time. Risks of BC or HF were low and risk estimates imprecise.

The Correlation Between Bladder Cancer and Obesity, Overweight, Physical Inactivity, and Tobacco Use: An Ecological Study in Asian Countries.

Background:Bladder cancer is the ninth most common cancer in the world.Objectives:This study aimed to determine the correlation between age-standardized incidence rates of bladder cancer and some risk factors in Asian countries through an extensive ecological analysis.Methods:This ecological study evaluated the correlation between age-standardized incidence rates of bladder cancer and obesity, overweight, physical inactivity, and tobacco use in 30 Asian countries. To determine the factors that were significantly related to age-standardized incidence rate of bladder cancer, a univariate analysis was performed using simple linear regression. In the next step, variables with p-values less than 0.25 were entered into a multivariate linear regression model.Results:The incidence of bladder cancer was higher in countries with higher prevalence of overweight (r2 = 0.36, p < 0.001), obesity (r2 = 0.34, p = 0.001), current daily tobacco use (r2 = 0.17, p = 0.03), and physical inactivity (r2 = 0.13, p = 0.04). The results of multiple regression analysis indicated a direct correlation between the incidence of bladder cancer and overweight (β = 0.15, p < 0.001) and current daily tobacco use (β = 0.21, p = 0.001).Conclusions:There was a significant relationship between the incidence of bladder cancer and overweight and current daily tobacco use. Further epidemiological studies are needed to confirm this relationship.