Bladder cancer is the 14th most common cause of cancer deaths worldwide and has a mean age of diagnosis of 73 years. Elderly people have fewer curative treatment options for muscle invasive bladder cancer. The aim of this study is to investigate how bladder cancer mortality has changed over the past forty years in different world regions to assess discrepancies between elderly and younger patients with bladder cancer.
Bladder cancer mortality data were extracted from the World Health Organisation’s GLOBOCAN database. Age-standardised mortality rates (ASMR) for bladder cancer were computed by year, sex, region and Human Development Index (HDI) using the world standard population.
Overall ASMR in all available countries with data between 1986 and 2014 for men aged ≥ 75 has decreased from 101.2 to 89.9 per 100,000 (−11.2%). The decrease in ASMR for men < 75 has been 0.3–2.0 per 100,000 (−39.4%). In women aged ≥ 75 ASMR has decreased from 26.9 to 22.5 per 100,000 (−16.4%) and in women < 75 the ASMR has decreased from 0.76 to 0.56 per 100,000 (−26.4%).
Correlation analysis showed a positive linear relationship between Human Development Index (HDI) and improvement in age-standardised mortality rate in all ages. Pearson’s coefficient showed that correlation was strongest in the 60–74 age group (r = −0.61, p < 0.001) and weakest in those aged ≥ 75 (r = −0.39, p = 0.01).
Bladder cancer mortality is not improving in the elderly at the same rate as the rest of the population. Particular focus should be applied in future research to enhance and expand treatment options for bladder cancer that are appropriate for elderly patients.
- • Global age-standardised mortality between 1986 and 2014 for bladder cancer has decreased by 11% in men ≥ 75 compared to 39% in men < 75.
- • Global age-standardised mortality between 1986 and 2014 for bladder cancer has decreased by 16% in women ≥ 75 compared to 26% in women < 75.
- • There is a positive linear relationship between a country’s Human Development Index and age-standardised mortality rate in all age groups with the correlation weakest in those aged ≥ 75.
Bladder cancer is the 14th most common cause of cancer deaths worldwide . Age is the greatest risk factor in developing bladder cancer and the median age of diagnosis in the US is 73 years of age . The combination of advanced age at diagnosis and a worldwide aging population will result in an increase in bladder cancer prevalence in the elderly . People aged ≥ 75 make up nearly half of new bladder cancer diagnoses but have fewer treatment opportunities than younger patients. Curative treatment of Muscle Invasive Bladder Cancer (MIBC) is centred around cystectomy, a relatively high morbidity operation with low prevalence in the elderly . Intra-vesical Bacillus Calmette-Guérin (BCG) for Non-Muscle Invasive Bladder Cancer (NMIBC) appears under-utilised in the elderly .
The aim of this study is to investigate how bladder cancer mortality has changed over the past forty years in different world regions and to assess discrepancies between elderly and younger patients with bladder cancer.