Bladder Cancer Outcomes in Women Vary over Time - Expert Commentary

Understanding differences in bladder cancer outcomes between men and women can help physicians tailor optimal treatment and follow-up strategies.

 A recent paper published by Richters et al. in Urologic Oncology: Seminars and Original Investigations studied the sex-specific mortality in bladder cancer patients. The study identified 24,169 patients who were recently diagnosed with ≥T1 bladder cancers between 2003 and 2014 using the Netherlands Cancer Registry. Of these, 5,824 (24%) were females. Patients were followed up until January 2018.  The investigators used flexible parametric survival models to analyze sex-specific excess mortality hazards over time.

Female patients had a worse clinical tumor, node, and metastasis-stage at diagnosis. The investigators found that female patients diagnosed with muscle-invasive bladder cancer had excess mortality rates during the first two years of diagnosis but better survival rates in later years. These results suggest that excess mortality in women was not constant over time.

Accurate clinical outcomes data collected prospectively are needed to confirm the temporal changes in cancer-specific mortality between men and women. Understanding the biological differences underlying differences in the natural history of the disease is critical for informing clinical management strategies.

Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine


1. Richters A, Dickman PW, Witjes JA, Boormans JL, Kiemeney LALM, Aben KKH. Bladder cancer survival: Women only fare worse in the first two years after diagnosis. Urol Oncol. 2019 Aug 31. pii: S1078-1439(19)30319-9. doi: 10.1016/j.urolonc.2019.08.001.

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