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Cited by 257Global Cancer Incidence and ScreeningBladder and Urothelial Cancer TreatmentsUrinary and Genital Oncology Studies

Global Trends of Bladder Cancer Incidence and Mortality, and Their Associations with Tobacco Use and Gross Domestic Product Per Capita

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Teoh, Jeremy Yuen-Chun, Huang, Junjie, Ko, Wendy Yuet-Kiu, Lok, Veeleah, Choi, Peter, Ng, Chi-Fai, Sengupta, Shomik, Mostafid, Hugh +5 more·2020·European Urology
DOI 10.1016/j.eururo.2020.09.006
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Abstract

BACKGROUND: Bladder cancer is a major urological disease, with approximately 550 000 new cases diagnosed in 2018. OBJECTIVE: We examined gender-specific incidence and mortality patterns, and trends of bladder cancer from a global perspective. We further investigated their associations with tobacco use and gross domestic product (GDP) per capita. DESIGN, SETTING, AND PARTICIPANTS: We retrieved data on the incidence and mortality of bladder cancer from the GLOBOCAN database, Cancer Incidence in Five Continents, and the WHO mortality database. Data on the rate of tobacco use were retrieved from the WHO Global Health Observatory. Data on GDP per capita was retrieved from the United Nations Human Development Report. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We performed two sets of analyses. The first set of analysis is based on bladder cancer incidence and mortality data in 2018. The gender-specific age-standardised rates (ASRs) of incidence and mortality, and their correlations with the rate of tobacco use and GDP per capita were investigated. A multivariable linear regression analysis was also performed. In the second set of analysis, we examined the 10-yr temporal trends of bladder cancer incidence and mortality by average annual percent change using joinpoint regression analysis. A further exploratory analysis on GDP per capita in countries with decreasing trends of tobacco use was also performed. RESULTS AND LIMITATIONS: Wide variations in bladder cancer incidence and mortality were observed globally. There were positive correlations between the rate of tobacco use and the ASRs of bladder cancer incidence (r=0.20) and mortality (r=0.38) in men, and between the rate of tobacco use and the ASRs of bladder cancer incidence (r=0.67) and mortality (r=0.22) in women. There were positive correlations between GDP per capita, and the ASRs of bladder cancer incidence in men (r=0.48) and women (r=0.44). There was a weak positive correlation between GDP per capita and bladder cancer mortality in men (r=0.19), but no correlation with bladder cancer mortality in women (r=0.06). Upon multivariable linear regression analysis, tobacco use was significantly associated with bladder cancer incidence and mortality in men, and bladder cancer incidence in women. Regarding the 10-yr temporal trends of bladder cancer, Europe has an increasing incidence but decreasing mortality, and Asia has a decreasing incidence but increasing male mortality. Among countries with decreasing trends of tobacco use, the mean GDP per capita was higher in countries with decreasing trends of bladder cancer mortality than in those with increasing trends of bladder cancer mortality. A major limitation of the study is that cancer incidence might be underdetected and under-reported in less developed nations. CONCLUSIONS: There were observable trends of bladder cancer incidence and mortality globally. Tobacco use was significantly associated with both bladder cancer incidence and mortality. A certain level of economic capacity might be needed to further reduce bladder cancer mortality in countries with a decreasing trend of tobacco use. PATIENT SUMMARY: There are different trends of bladder cancer incidence and mortality globally. Smoking is significantly associated with the incidence and mortality of bladder cancer. A higher financial capacity may be needed to further improve the disease outcomes.

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  • Diverging bladder cancer incidence trends have been observed by sex since the 1990s, with rates tending to decrease or stabilize in men but increase among women in certain European countries (e.g., in Spain, the Netherlands, Germany, and Belarus).

    “Diverging bladder cancer incidence trends have been observed by sex since the 1990s, with rates tending to decrease or stabilize in men but increase among women in certain European countries (e.g., in Spain, the Netherlands, Germany, and Belarus).160,162,163”

    From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [162]

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Research works printed but not linked: 1

  1. Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000;19:335-51.

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Authors
Teoh, J. Y.-C., Huang, J., Ko, W. Y.-K., Lok, V., Choi, P., Ng, C.-F., Sengupta, S., Mostafid, H., Kamat, A. M., Black, P. C., Shariat, S., Babjuk, M., & Wong, M. C.-S.
Affiliations
  • Chinese University of Hong Kong (HK)
  • Eastern Health (AU)
  • Royal Surrey County Hospital (GB)
  • The University of Texas MD Anderson Cancer Center (US)
  • University of British Columbia (CA)
  • University of Jordan (JO)
  • Charles University (CZ)
Corresponding author
Wong, Martin Chi-Sang
ORCID
Venue
European Urology
Publisher
Elsevier BV
Published
2020-12
Volume
78
Issue
6
Pages
893-906
ISSN
0302-2838 (ISSN-L)
DOI
10.1016/j.eururo.2020.09.006
OpenAlex
W3088359032
Cited by
257
References
33
Citations by year
2026: 27 · 2025: 46 · 2024: 64 · 2023: 48 · 2022: 43 · 2021: 25 · 2020: 3
FWCI
10.74
Type
journal article
Language
en
Open access
Licence
Locations
  • European Urology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Surgery › Bladder and Urothelial Cancer Treatments
  • Health Sciences › Medicine › Surgery › Urinary and Genital Oncology Studies
Keywords
bladder cancer, cancer incidence, cancer mortality, tobacco use, GDP per capita, gender differences, temporal trends, age-standardized rates, economic development, bladder cancer risk factors, global cancer epidemiology, Europe, Asia, United States, Australia, Canada, South America, Africa, Middle East, Pacific Islands, Oceania, South Asia, Southeast Asia
MeSH terms
Urinary Bladder Neoplasms, Female, Humans, Male, Global Health, Incidence, Sex Distribution, Gross Domestic Product, Tobacco Use

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