Gender-related differences in urothelial carcinoma of the bladder: a population-based study from the Swedish National Registry of Urinary Bladder Cancer

OBJECTIVE - The aim of this investigation was to describe tumour characteristics, treatments and survival in patients with urinary bladder cancer (UBC) in a national population-based cohort, with special reference to gender-related differences.

MATERIALS AND METHODS - All primary UBC patients with urothelial pathology reported to the Swedish National Registry of Urinary Bladder Cancer (SNRUBC) from 1997 to 2011 were included in the study. Groups were compared regarding tumour, node, metastasis classification, primary treatment and survival.

RESULTS - In total, 30,310 patients (74.9% male, 25.1% female) with UBC were analysed. A larger proportion of women than men had stage T2-T4 (p < 0.001), and women also had more G1 tumours (p < 0.001). However, compared to women, a larger proportion of men with carcinoma in situ or T1G3 received intravesical treatment with bacillus Calmette-Guérin or intravesical chemotherapy, and a larger proportion of men with stage T2-T4 underwent radical cystectomy (38% men vs 33% women, p < 0.0001). The cancer-specific survival at 5 years was 77% for men and 72% for women (p < 0.001), and the relative survival at 5 years was 72% for men and 69% for women (p < 0.001).

CONCLUSIONS - In this population-based cohort comprising virtually all patients diagnosed with UBC in Sweden between 1997 and 2011, female gender was associated with inferior cancer-specific and relative survival. Although women had a higher rate of aggressive tumours, a smaller proportion of women than men received optimal treatment.

Scandinavian journal of urology. 2016 Mar 22 [Epub ahead of print]

Andreas Thorstenson, Oskar Hagberg, Börje Ljungberg, Fredrik Liedberg, Georg Jancke, Sten Holmäng, Per-Uno Malmström, Abolfazl Hosseini, Staffan Jahnson

a Department of Molecular Medicine and Surgery, Section of Urology , Karolinska Institute , Stockholm , Sweden ;, c Regional Cancer Center, Lund University , Lund , Sweden ;, d Department of Surgical and Perioperative Sciences, Urology and Andrology , Umeå University , Umeå , Sweden ;, e Department of Urology , SUS, Lund University , Malmö , Sweden ;, f Department of Urology , University Hospital, Linköping University , Linköping , Sweden ;, g Department of Urology , Sahlgrenska University Hospital , Göteborg , Sweden ;, h Department of Urology , Uppsala University Hospital , Uppsala , Sweden., a Department of Molecular Medicine and Surgery, Section of Urology , Karolinska Institute , Stockholm , Sweden ;, f Department of Urology , University Hospital, Linköping University , Linköping , Sweden ;

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