Epidemiology

Urothelial cancer:

• is uncommon before 50 years of age
• is most frequent in incidence at 65 years of age
• is more common in males by a factor of 3:1(1)
• bladder cancer is the seventh most common cancer in the UK. It is 3-4 times more common in men than in women. In the UK in 2011, it was the fourth most common cancer in men fand the thirteenth most common in women (2)
  • 10,399 people diagnosed with bladder cancer and 5081 deaths from bladder cancer in 2011
  • majority of cases occur in people aged over 60
  • main risk factor for bladder cancer is increasing age, but smoking and exposure to some industrial chemicals also increase risk
• 95% affect the bladder; 5% affect the upper tracts
• in 90% of cases, presentation is with macroscopic haematuria (1)
• 5-10% of patients present with microscopic haematuria
• is four times as common as renal adenocarcinoma
• has a 20 times more common incidence in paraplegics
• is common in industrialised countries
• is uncommon in the developing world except in bilharzial areas

Note that both microscopic and macroscopic haematuria, when caused by a urothelial cancer are intermittent. Therefore repeat urine testing can be negative for haematuria in the presence of a tumour (1).

Reference:

• (1) Referral Guidelines for Suspected Cancer (April 2000). NHS Executive.
• (2) NICE (February 2015). Bladder cancer: diagnosis and management of bladder cancer