4.6 Review

Global trends in the epidemiology of bladder cancer: challenges for public health and clinical practice

Journal

NATURE REVIEWS CLINICAL ONCOLOGY
Volume 20, Issue 5, Pages 287-304

Publisher

NATURE PORTFOLIO
DOI: 10.1038/s41571-023-00744-3

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Bladder cancer is a significant burden for healthcare systems worldwide due to its high incidence and mortality. The occurrence of bladder cancer is influenced by factors such as population growth, aging, and exposure to risk factors like tobacco smoking. Primary prevention efforts are crucial in reducing the burden of bladder cancer, and less-invasive diagnostic approaches using urinary biomarkers show promise. Increasing awareness of risk factors and symptoms among healthcare professionals and high-risk groups is also important. Further research on the relationship between lifestyle factors and bladder cancer outcomes should be prioritized.
Bladder cancer is among the ten most common cancers globally, causes considerable morbidity and mortality and is, therefore, a substantial burden for health-care systems. The incidence of bladder cancer is affected by demographic trends, most notably population growth and ageing, as well as exposure to risk factors, especially tobacco smoking. Consequently, the incidence has not been stable throughout the world over time, nor will it be in the near future. Further primary prevention efforts are of the utmost importance to reduce the medical and financial burden of bladder cancer on populations and health-care systems. Simultaneously, less-invasive and lower-cost approaches for the diagnosis of both primary and recurrent bladder cancers are required to address challenges posed by the increasing shortage of health-care professionals and limited financial resources worldwide. In this regard, urinary biomarkers have demonstrated promising diagnostic accuracy and efficiency. Awareness of the risk factors and symptoms of bladder cancer should also be increased in society, particularly among health-care professionals and high-risk groups. Studies investigating the associations between lifestyle factors and bladder cancer outcomes are scarce and should be a research priority. In this Review, we outline global trends in bladder cancer incidence and mortality, and discuss the main risk factors influencing bladder cancer occurrence and outcomes. We then discuss the implications, challenges and opportunities of these epidemiological trends for public health and clinical practice. Bladder cancer is among the ten most common cancers worldwide and therefore constitutes a substantial health-care burden. This Review summarizes the global trends in bladder cancer incidence and mortality, and describes the main risk factors associated with bladder cancer occurrence and outcomes. The implications, challenges and opportunities of these epidemiological trends for public health and clinical practice are also discussed.

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