Partitioning of time trends in prevalence and mortality of bladder cancer in the United States

Purpose: The aim of the study was to evaluate the relative contributions of incidence, stage-specific relative survival, and stage ascertainment to changes in bladder cancer (BC) prevalence and incidence-based mortality. Methods: Partitioning of prevalence and incidence-based mortality trends into their epidemiologic components. Results: BC prevalence estimated from our model increased but at monotonically decreasing rates until 2007, after which it decreased again. The main forces underlying observed trends in BC prevalence were relative BC survival, which improved throughout the period, and BC incidence, which increased at a decreasing rate until 2005 and declined thereafter. Mortality of persons ever diagnosed with BC increased at an increasing rate until 1997, increased at a decreasing rate from 1997 to 2005, and decreased thereafter. The primary forces accounting for mortality trends were changes in mortality in the general population, which improved at an increasing rate during most of 1992-2010, the most important factor, and changes in incidence. Stage ascertainment did not improve during 1992-2010. Conclusions: Although mortality rates improved, these gains largely reflected improvements in U.S. population survival rather than from improvements in BC-specific outcomes. (C) 2020 Elsevier Inc. All rights reserved.