Bladder cancer - survival statistics for England and Wales

The most important prognostic factor is the depth of tumour penetration into the bladder wall: T staging of bladder cancer is shown in Figure 3.1. 1,2

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Tumours not invading beyond the lamina propria (T1) are classified as superficial. Other prognostic factors include multiple tumour foci, grade and tumour type. Patients with superficial tumours have an excellent prognosis with five-year survival rates between 80-90%. Patients with muscle-invasive bladder cancer have five-year survival rates of less than 50%. Radical treatment deals effectively with locally invasive disease but many patients die from metastatic disease. Early detection while the tumour is still superficial is therefore very important.

One and five-year relative survival rates have risen consistently as Figure 3.2 shows for men and women diagnosed from the early 1970s to 2000/01. 3-5

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Over this time period, one-year relative survival rates rose from 66-81% for men and 59-71% for women while five-year relative rates rose from 44-66% for men and 42-57% for women. An unusual feature of these survival rates is that men have consistently higher survival rates than women (among common cancers in England and Wales only two cancers, larynx and bladder, have significantly higher male than female survival rates) . This male survival advantage for bladder cancer is seen in many countries. 6 Men seem to be diagnosed at a slightly earlier stage than women but this does not explain all their survival advantage, as stage-specific survival is also higher in men than women 7,8

It has been suggested that the different anatomy of male and female bladders may account for some of the variation in survival between the sexes. 8 However, survival for both men and women decreases strongly with age ( Figure 3.3). 3

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It is possible that differences in survival over time, between sexes and ages, have been influenced by changes in defining malignant bladder tumours. 4

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