Mario I Fernández1,2, Maurizio Brausi3, Peter E Clark4, Michael S Cookson5, H Barton Grossman6, Makarand Khochikar7, Lambertus A Kiemeney8, Bernard Malavaud9, Rafael Sanchez-Salas10, Mark S Soloway11, Robert S Svatek12, Raghunandan Vikram13, Alina Vrieling8, Ashish M Kamat14. 1. Department of Urology, Clínica Alemana, Santiago, Chile. 2. Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. 3. Prostate Cancer Unit, B. Ramazzini Hospital, Modena, Italy. 4. Department of Urology, Atrium Health, Levine Cancer Institute, Charlotte, NC, USA. 5. Department of Urology, The University of Oklahoma Health Sciences Center & The Stephenson Cancer Center, Oklahoma City, OK, USA. 6. Department of Urology, Unit 1373, The University of Texas MD Anderson Cancer Center, 1155 Pressler, Houston, TX, 77030, USA. 7. Department of Urology, Siddhi Vinayak Ganapati Cancer Hospital, Miraj, India. 8. Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. 9. Department of Urology, Toulouse Cancer Institute, Toulouse, France. 10. Department of Urology, L'Institut Mutualiste Montsouris, Paris, France. 11. Department of Urology, Memorial Healthcare System, Miami, FL, USA. 12. Department of Urology, University of Texas Health, San Antonio, TX, USA. 13. Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 14. Department of Urology, Unit 1373, The University of Texas MD Anderson Cancer Center, 1155 Pressler, Houston, TX, 77030, USA. akamat@mdanderson.org.
Abstract
PURPOSE: To update current recommendations on prevention, screening, diagnosis, and evaluation of bladder cancer (BC) based on a thorough assessment of the most recent literature on these topics. METHODS: A non-systematic review was performed, including articles until June 2017. A variety of original articles, reviews, and editorials were selected according to their epidemiologic, demographic, and clinical relevance. Assessment of the level of evidence and grade of recommendations was performed according to the International Consultation on Urological Diseases grading system. RESULTS: BC is the ninth most common cancer worldwide with 430,000 new cases in 2012. Currently, approximately 165,000 people die from the disease annually. Absolute incidence and prevalence of BC are expected to rise significantly during the next decades because of population ageing. Tobacco smoking is still the main risk factor, accounting for about 50% of cases. Smoking cessation is, therefore, the most relevant recommendation in terms of prevention, as the risk of developing BC drops almost 40% within 5 years of cessation. BC screening is not recommended for the general population. BC diagnosis remains mainly based on cystoscopy, but development of new endoscopic and imaging technologies may rapidly change the diagnosis algorithm. The same applies for local, regional, and distant staging modalities. CONCLUSIONS: A thorough understanding of epidemiology, risk factors, early detection strategies, diagnosis, and evaluation is essential for correct, evidence-based management of BC patients. Recent developments in endoscopic techniques and imaging raise the hope for providing better risk-adopted approaches and thereby improving clinical outcomes.
PURPOSE: To update current recommendations on prevention, screening, diagnosis, and evaluation of bladder cancer (BC) based on a thorough assessment of the most recent literature on these topics. METHODS: A non-systematic review was performed, including articles until June 2017. A variety of original articles, reviews, and editorials were selected according to their epidemiologic, demographic, and clinical relevance. Assessment of the level of evidence and grade of recommendations was performed according to the International Consultation on Urological Diseases grading system. RESULTS: BC is the ninth most common cancer worldwide with 430,000 new cases in 2012. Currently, approximately 165,000 people die from the disease annually. Absolute incidence and prevalence of BC are expected to rise significantly during the next decades because of population ageing. Tobacco smoking is still the main risk factor, accounting for about 50% of cases. Smoking cessation is, therefore, the most relevant recommendation in terms of prevention, as the risk of developing BC drops almost 40% within 5 years of cessation. BC screening is not recommended for the general population. BC diagnosis remains mainly based on cystoscopy, but development of new endoscopic and imaging technologies may rapidly change the diagnosis algorithm. The same applies for local, regional, and distant staging modalities. CONCLUSIONS: A thorough understanding of epidemiology, risk factors, early detection strategies, diagnosis, and evaluation is essential for correct, evidence-based management of BC patients. Recent developments in endoscopic techniques and imaging raise the hope for providing better risk-adopted approaches and thereby improving clinical outcomes.
Entities:
Keywords:
Cystoscopy; Early detection of cancer; Neoplasm staging; Neoplasm, urinary bladder; Primary prevention; Risk factor
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