• Peak age 6^th to 8^th decades
• Male to female approximately 3:1
• Race twice as common in white vs. African American men. Outcomes generally poorer in black men, especially in black women
• Genetics mutations and dysfunction in the genes regulating the cell cycle play a major role in the development of bladder cancer. Initiation of superficial disease is probably due to the alteration of several genes on chromosome 9 including p16 ^ink/arf. Early events in muscle invasive disease include p53 and Rb alterations as well as expression of p21.
• Bladder cancer is the 7^th most common cancer death in men and 10-12^th most common cancer death in women. There has been a 50% increase in incidence over the past 40 years.
• Some evidence for the effectiveness of hematuria screening has be noted in a few small case control studies in higher risk populations, but can not be applied as a general recommendation .

References

• Droller MJ: Bladder: Anatomical overview in surgical management of urologic disease: An anatomic approach, MJ Droller, St. Louis, Mosby Yearbook, p 575, 1992.
• Herr HW, Schwalb DM, Zhang ZF, et al: Intravesical bacillus Calmette-Guerin therapy prevents tumor progression and death from superficial bladder cancer: Ten-year follow-up of a prospective randomized trial. J Clin Oncol 13:1404, 1995.
• Lamm DL: Complications of bacillus Calmette-Guerin immunotherapy. Urol Clin North Am 19:565, 1992.
• Malkowicz SB: Superficial bladder cancer: The role of molecular markers in the treatment of high-risk superficial disease. Semin Urol Oncol 15:169-178, 1997.
• Messing EM, Catalona W: Urothelial tumors of the urinary tract. In: Campbell's Urology 7th ed. PC Walsh, AB ED Vaughan, AJ Wein, Vol 3, Chap 77, 2327, 1998.
• Spruck CH, Ohneseit PE, Gonzalez-Zulueta M, et al: Two molecular pathways to transitional cell carcinoma of the bladder. Cancer Res 54:784-788, 1994.

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