Bladder cancer - UK incidence statistics

Bladder cancer is a common cancer in the UK, with 10,335 new cases diagnosed in 2008. 1-4 It is the most frequently occurring tumour of the urinary system and accounts for around 1 in every 30 new cases of cancer each year in the UK. In the UK bladder cancer is the fourth most common cancer in males, with 7,390 new cases diagnosed in 2008. 1-4 This compares to 2,945 female cases, giving a male:female ratio of 5:2. In females it is the eleventh most common cancer.

The numbers and rates for the UK and its constituent countries are shown in Table 1.1. 1-4

Table 1.1: Bladder Cancer (C67), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population,  UK, 2008

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

Few cases occur under the age of 50, but thereafter the rates rise with age to reach a peak in the oldest age-groups when rates in elderly men are more than three times higher than in elderly women (Figure 1.1). 1-4

Figure 1.1: Bladder Cancer (C67), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2006-2008

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It has been estimated that the lifetime risk of developing bladder cancer is approximately 1 in 40 for men and approximately 1 in 108 for women in the UK. These were calculated in May 2011 using incidence and mortality data for 2008 using the AMP method.5

Section updated 25/05/11

British data show only a small deprivation gradient, with the lowest bladder cancer incidence rates recorded for the most affluent and the highest for the most deprived groups.7 Analysis for data from England showed similar results with age-standardised bladder cancer incidence rates of 11.2 per 100,000 population for the most affluent compared with 13.7 for the most deprived. 8 

Section updated 17/12/10

In a recent study comparing bladder cancer incidence across ethnic groups in England,9 age-standardised rates for the males in the white ethnic group ranged from 19.9 to 20.5 per 100,000 for all ages. Rates for the asian ethnic group were significantly lower for all ages, ranging from 6.5 to 10.1 per 100,000 and the rates for the black ethnic group were also significantly lower, ranging from 5.6 to 9.6 per 100,000. For females there was a similar pattern- the age-standardised rates for the white ethnic group ranged from 5.7 to 6.0 per 100,000 for all ages, whereas the rates for the asian and black ethnic groups were significantly lower- 1.3 to 2.7 per 100,000 and 1.6 to 3.7 per 100,000 respectively.

Section updated 25/05/11

An analysis of cancer incidence in the UK and Ireland highlighted considerable differences between cancer registries in the classification of bladder tumours which make the interpretation of any geographical patterns difficult. 10 These differences in registration practice will also limit international comparisons.

The 2008 estimated age-standardised bladder cancer incidence rates reported for UK men are well below the EU average (18.5 v 27.4 per 100,000 population respectively) and the rate for women in the UK is slightly lower (5.1 v 5.6 per 100,000 population respectively) as Figure 1.2 shows.18

Figure 1.2: Bladder Cancer (C67), European Age-Standardised Incidence Rates, EU-27 Countries, 2008 Estimates

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Worldwide an estimated 382,660 new cases of bladder cancer occur each year and, in terms of overall cancer frequency, it is ranked sixth. 11  Figure 1.3 shows bladder cancer incidence rates worldwide.

Figure 1.3: Bladder Cancer (C67), World Age-Standardised Incidence Rates, World Regions, 2008 Estimates

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The highest bladder cancer incidence rates are generally found in industrially developed countries, particularly in North America and Southern and Western Europe, and in areas associated with endemic schistosomiasis12 in Africa and the Middle East.

Marked racial differences have been reported for bladder cancer incidence with higher rates in white than non-white populations. For example, in the USA, rates for white men are double those for black men: in 2000-2003 the age-adjusted incidence rate per 100,000 population was 40.2 for white males compared to 19.8 in black Americans. Bladder risk for US black women is about two-thirds that of US white women. 13

These differences may be partly due to genes, as studies have shown that certain genetic polymorphisms linked to an increased risk of bladder cancer (for example, the NAT2 slow acetylator polymorphism) are much more prevalent in white than non-white populations 14 - see  Molecular Biology and Genetics section for more details.

Section updated 29/06/11

Time trends in bladder cancer incidence rates are difficult to interpret because of different and changing classification/coding practices affecting the definition of invasive carcinoma of the bladder.

In Great Britain, the age-standardised incidence rates per 100,000 population rose throughout the 1970s and 1980s to reach a peak of 31 in men and 9 in women in the early 1990s. Since then male rates have fallen by more than a third (37%). For females rates have decreased by a third (34%) (Figures 1.4 and 1.5). 15

Figure 1.4: Bladder Cancer (C67), European Age-Standardised Incidence Rates, Great Britain, 1975-2008

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Figure 1.5: Bladder Cancer (C67), European Age-Standardised Incidence Rates, UK, 1993-2008

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The age-specific bladder cancer incidence rates in Great Britain Figure 1.6 and Figure 1.7 show a consistent decrease since the early 1990s for all age-groups under age 85. 15 Some of this decrease is likely to be due to an increasing proportion of bladder tumours now being coded as in situ or uncertain 16, but reductions in smoking and exposure to occupational carcinogens may also have played a role, especially as the mortality rates have also decreased.17

Figure 1.6: Bladder Cancer (C67), European Age-Standardised Incidence Rates, Males, By Age-Group, Great Britain, 1975-2008

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Figure 1.7: Bladder Cancer (C67), European Age-Standardised Incidence Rates, Females, By Age-Group, Great Britain, 1975-2008

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Section updated 25/05/11

In developed countries around 90% of bladder cancers are transitional cell carcinomas while the remaining 10% are squamous cell carcinomas and adenocarcinomas. Benign transitional cell papillomas have sometimes and in some places been registered as invasive carcinomas. This variation in registration practice has to be taken into account when comparing incidence and survival rates over time and place. 10

Where the bladder cancer is associated with chronic bladder infection, most commonly with waterborne parasitic flatworms called schistosomes, the usual histology is squamous cell carcinoma. Schistosomiasis-associated bladder cancer has an earlier mean age at onset, typically in the fifth decade of life, and tends to present at a later stage than transitional cell carcinomas.

In countries where schistosomiasis (also called bilharzia ) is endemic, such as Egypt, bladder cancer is the most common cancer in men. 11 Prevention of infection in these countries is paramount. 12 Subsequent information in this section concerns bladder cancer in the UK and other developed countries unless otherwise specified.

Section updated 17/12/10

Prevalence data relates to those people of the UK population who were alive on a specific date having previously been diagnosed with cancer. The latest analysis shows that on 31st December 2006, around 46,500 people were alive up to ten years after being diagnosed with bladder cancer6. Table 1.2 shows the one, five and ten year prevalence by sex for bladder cancer.

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Section updated 13/06/10