Are We Making Significant Progress in the Diagnosis and Management of Bladder Cancer?

University of Chicago Medical Center, Chicago, Illinois.
The Journal of urology (Impact Factor: 4.47). 03/2010; 183(5):1667-8. DOI: 10.1016/j.juro.2010.02.2376
Source: PubMed
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    ABSTRACT: In this issue, Kato et al provide an alternative method for estimating elevated rates of cancer in the immigrant population, with a focus on Arab immigrants. Their work and others has demonstrated: (1) higher rates for some cancer sites in the home countries1 and, (2) variation in rates for cancer sites in migrants to the United States.2,3 The information on US migrants tends to be limited both by the definition of the populations in both the numerator and the denominator being used and the size of the populations under study. The Kato study expands this literature by utilizing the Surveillance, Epidemiology, and End Results (SEER) Program database reflecting a representative sample of the US population and addressing a methodological issue which limits descriptive epidemiology of this population- the lack of denominator data from the US census.
    J Registry Manag 09/2009; 36(3):95.
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    J Registry Manag 01/2010; 37(4):133-6.
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    ABSTRACT: A total of 356,557 new cases were diagnosed annually worldwide in 2009, it was estimated that 52,810 new patients were to be diagnosed with bladder cancer and there were 10,180 projected deaths from the disease in the USA. Despite being the fourth commonest cancer in men, we do not have an early detection/screening program for bladder cancer. The review was aimed at looking at the evidence for the rationale for an early detection program for bladder cancer. A detailed search on bladder cancer epidemiology, diagnosis, pathology, tumor markers, treatment outcomes, screening, morbidity and mortality of bladder cancer was carried out on Pubmed central/Medline. Original articles, review articles, monograms, book chapters on bladder cancer, text books on urological oncology, oncology and urology were reviewed. The latest information for new articles before publication was last accessed in June 2010. Bladder cancer is the fourth commonest cancer in men, the annual death rate from this disease is significant and every year there is an increase in its incidence globally. The prognosis of bladder cancer is stage and grade dependent; the lower the stage (T2 or less) the better is the survival. Delay in the diagnosis and treatment does alter the overall outcome. Therefore, there is a clear need for early detection of bladder cancer and screening program. Although we do not have an ideal marker for bladder cancer, it is time we maximize the potential of markers such as UroVysion, NMP22 along with cytology to start such a program. May be as a first step the early detection and screening program could be started in high-risk population. It is not worth waiting till we find the best marker as it would be unfair to our patients. The fear of unnecessary tests and treatment in bladder cancer after its detection in screening program is without any substance. The cost-effectiveness of such a program is certainly comparable to that is used for colon or breast and for prostate as well.
    Indian Journal of Urology 04/2011; 27(2):218-25. DOI:10.4103/0970-1591.82841

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