Bladder Cancer Challenge

High unmet needs for detection, diagnosis and management in the early, non-muscle-invasive stages of bladder cancer.

Bladder cancer is a major challenge around the world. Improving the way this disease is detected, diagnosed and managed, can save lives. Equally important, it can improve patients' quality of life, while helping health systems and payers to reduce costs and provide care to more people.

A frequently occurring cancer

Bladder cancer is a huge and growing challenge globally. Bladder cancer ranks as the seventh most common cancer worldwide with 1,720,000 prevalent cases (5-year prevalence rate), 573,000 new cases and more than 200,000 deaths annually in 2020.1
Approximately 75% of all bladder cancer cases occur in men.1 It has a high recurrence rate with an average of 61% in year one and 78% over five years.2 

573,000 new cases

New cases of bladder cancer1

3.0% of cancers

Bladder cancer as a percentage of all new cancer cases3

212,500 deaths

Estimated deaths from bladder cancer 20201

4th most prevalent cancer in men

Bladder cancer affects men more frequently than women. It is the 7th most prevalent cancer in both sexes worldwide, the 4th in men. The disease tends to occur mainly in older people: approximately 79% of people diagnosed with bladder cancer are above 55 years old.1,3

Types and stages of bladder cancer

Bladder cancer is a disease of abnormal cell growth in the bladder. In its initial phase, the abnormal cell growth is usually confined to the lining of the bladder. At that stage, it is referred to as non-muscle invasive bladder cancer (NMIBC). However, the cancerous cells may grow into the muscular wall of the bladder, at which stage it is described as muscle-invasive bladder cancer (MIBC). If still uncontrolled, the cancerous condition can spread to other adjacent or distant organs.

Bladder cross section

Reproduced from Bladder Cancer: A Patient-Friendly Guide to Understanding Your Diagnosis and Treatment Options. Copyright © 2017 David Pulve

Bladder cancer is classified into two types, depending on the depth of invasion in the bladder wall:

  • Non-muscle invasive bladder cancer (NMIBC) is restricted to the inner layer of cells that line the bladder. The most common (75 percent) of all bladder cancer cases, include the subtypes Ta, carcinoma in situ (CIS) and T1 lesions.
  • Muscle-invasive bladder cancer (MIBC) refers to the stage where the cancer has grown into the muscle layers of the bladder wall. These cancers are more likely to spread to other organs and are harder to treat. These cancers include the subtypes T2, T3 and T4.

Bladder Cancer Stages

Early bladder cancer detection, diagnosis and management

As with many other cancers, early detection and accurate diagnosis are important factors for successfully managing bladder cancer and battling against recurrence.

Approximately 75% of bladder cancers are diagnosed while the cancer is still inside the inner layer of the bladder wall. This stage of cancer is called non-invasive bladder cancer or NMIBC.3

To diagnose bladder cancer based on urinary symptoms, the physician collects the patient's medical history and performs urine tests and cultures, to check for blood, infections and other abnormal cells. If there are suspicions of bladder cancer or positive findings from testing, a urologist will perform cystoscopy to look into the patient's bladder.

Learn more about cystoscopy.

Cystoscopy is an endoscopic procedure allowing the examiner to look inside the bladder through a camera device inserted through the urethra. The procedure may be uncomfortable but should not be painful. If any areas of suspicious of cancer are observed at the first cystoscopy, the patient will typically be referred for a surgical procedure called transurethral resection of bladder tumor, (TURBT) in the operating room.

During the TURBT procedure, suspected areas will be biopsied and removed. Tissue analysis of the biopsy or resected area will provide basis for a diagnosis, including the disease's stage and grade (level of development). Frequently, some additional examinations like radiological imaging will be performed to get the full overview of disease.

All these factors will be used to calculate the individual patient's risk level and a program for treatment and follow up will be lined out. Regular cystoscopy controls are performed to check for recurrence of disease.2

Learn more about the patient's bladder cancer journey.

Survival rates for bladder cancer

Disease stage and –grade at time of diagnosis are important factors for the prognosis of bladder cancer. Early detection of cancer and cancer recurrence play a significant role in management and survival of the cancer.

Survival rates:6

5 year 77%

10 year 70%

15 year 65%

Expensive to manage

Bladder cancer is a costly, potentially progressive disease for which patients have to undergo multiple cystoscopies due to the high risk of recurrence. There is an urgent need to improve both the diagnosis and the management of bladder cancer for the benefit of patients and healthcare systems alike.
The paper, "Economic Burden of Bladder Cancer Across the European Union"4 estimates that bladder cancer cost the EU €4.9 billion in 2012. This amounted to 3 percent of all cancer costs. It is estimated that upwards of $5.71 billion will be spent on bladder cancer in the US in the year 2020.5
The scale of this cost underlines the need to improve both the diagnosis and the management of bladder cancer for the benefit of patients, healthcare systems and payers.

An opportunity to transform bladder cancer management

Better control of bladder cancer can save lives, improve the quality of life of patients and reduce the cost of managing it. Essential steps to better control are early and accurate diagnosis, complete resection of all tumor tissue and early detection and treatment of recurrent cancer or cancer progression.

Learn more about bladder cancer treatment options.

 

References:

1 Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today, accessed [April 2021]

2 Babjuk M, et al. Eur Urol. 2019; 76(5): 639-657

3 Bladder Cancer. American Cancer Society. https://www.cancer.org/cancer/bladder-cancer.html

4 Leal, et al, 2016

5 Mariotto AB, et al, J Natl Cancer Inst. 2011;103(2):117-28.

6 Survival rates for bladder cancer, Source: Cancer.net