We report NHS England data for patients with bladder cancer (BC), upper tract urothelial (UTUC: renal pelvic and ureteric) and urethral cancers from 2013 to 2019.
Hospital episode statistics, waiting times and cancer registrations were extracted from NHS Digital.
Registrations included 128,823 individuals with BC, 16,018 with UTUC and 2,533 with urethral cancer. In 2019, 150,816 persons were living with a diagnosis of BC, of whom 113,067 (75.0%) were men, 85,117 (56.5%) aged over 75 yrs, and 95,553 (91.7%) Caucasian. Incidence rates were stable (32.7-34.3 for BC, 3.9-4.2 for UTUC and 0.6-0.7 for urethral cancer per 100,000 population). Most patients (52,097 (41.3% (40.7-42.0%)) were referred outside the two week wait pathway and 15,340 (12.2% (11.7-12.6%)) presented as emergencies. Surgery, radiotherapy, chemotherapy or multimodal treatment use varied with disease stage, patient factors and Cancer Alliance. Between 27-29% (6,616) of muscle-invasive BCs did not receive radical treatment. Survival rates reflected stage, grade, location and tumour histology. Overall survival rates did not improve over time (relative change: 0.97 (95%CI: 0.97-0.97) at 2 years) in contrast to other cancers.
The diagnostic pathway for BC needs improvement. Increases in survival might be delivered through greater use in radical treatment. NHS Digital data offers a population-wide picture of this disease but does not allow individual outcomes to be matched with disease or patient features and key parameters can be missing or incomplete.
BJU international. 2023 Jan 20 [Epub ahead of print]
James W F Catto, Olena Mandrik, Lewis A Quayle, Syed A Hussain, John McGrath, Joanne Cresswell, Alison J Birtle, Rob J Jones, Paramananthan Mariappan, Lydia E Makaroff, Allen Knight, Hugh Mostafid, Jim Chilcott, Peter Sasieni, Marcus Cumberbatch
Department of Oncology and Metabolism, University of Sheffield, S10 2RX, UK., Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, S1 4DA, UK., Department of Urology, Royal Devon University Hospitals Foundation Trust and University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK., South Tees NHS Hospitals Trust, Middlesborough, UK., Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, PR2 9HT, UK., School of Cancer Sciences, University of Glasgow, Beatson West of Scotland Cancer Centre, G12 0YN., Edinburgh Bladder Cancer Surgery, Department of Urology, Western General Hospital, Edinburgh, UK., Fight Bladder Cancer, Oxfordshire, OX39 4DJ, UK., Patient and Trustee, Action Bladder Cancer UK, UK., Department of Urology, The Royal Surrey County Hospital, Guildford, UK., School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.