Bladder cancer: twenty years of progress and the challenges that remain.

The most obvious improvements in the care of patients with bladder cancer over the past 20 years are bacille Calmette-Guérin immunotherapy for superficial bladder cancer and cisplatin and methotrexate-based combination chemotherapy for advanced disease. The challenges that remain are prevention, early detection, and improved treatment of both superficial and advanced disease. Meeting these challenges requires research, financial investment, and public education.