Adult UrologyGender differences in stage distribution of bladder cancer
Section snippets
Material and methods
The Netherlands Cancer Registry is a population-based cancer registry. All bladder malignancies, including carcinoma in situ and noninvasive bladder cancer, diagnosed from 1989 to 1994 in people living in The Netherlands were registered nationwide. The cancer registry collects the data according to a minimum data set, which includes identification data (eg, name, date of birth, sex, and postal code) and tumor data (eg, topography, morphology, stage, and date of incidence). The minimum data set
Results
The study population consisted of 21,795 patients with bladder cancer who were reported to The Netherlands Cancer Registry between 1989 and 1994. Of these 21,795 tumors, 20,541 (94.3%) were TCC, of which 16,415 were in male patients (79.9%) and 4126 were in female patients (20.1%), giving a male/female ratio of 4:1. The 1254 non-TCC bladder tumors accounted for 5.7%, of which 800 were in male patients (63.8%) and 454 in female patients (36.2%). Male patients had more superficial TCC (pTa, pT1,
Comment
Trends in stage distribution between the two sexes have been described using several statistical methods and different staging systems. The use of different staging systems makes it difficult to compare various population groups. Moreover, whether gender differences in bladder cancer exist remains controversial at present because of some contradictory reports.1, 2, 3
In a retrospective Spanish study on TCC of the bladder between 1975 and 1991, 440 patients with superficial and 117 patients with
Conclusions
Stage distribution differences were observed between men and women with bladder cancer and TCC of the UUT in this large series. These differences were more significantly evident in non-TCC bladder tumors. Despite the explanations mentioned, bladder cancer remains a challenge for further studies. However, female patients should be investigated carefully, and physicians should be aware of the possibility of higher stages of bladder cancer in women in whom bladder cancer is diagnosed.
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