Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends

Abstract

Background and objective: Bladder cancer is the most common tumor of the urinary tract and the ninth most common cancer worldwide. Our objective was to describe and interpret current geographic variations in bladder cancer incidence and mortality rates using updated national estimates and recorded data from population-based cancer registries alongside national vital statistics.

Methods: The bladder cancer incidence and mortality for 185 countries by sex were obtained from GLOBOCAN (International Agency for Research on Cancer) for the year 2022. Recorded incidence and mortality data were retrieved from national or subnational population-based cancer registries included in the Cancer Incidence in Five Continents series and the World Health Organization database, respectively. Corresponding age-standardized rates (ASRs) per 100000 person-years were calculated using direct standardization (world standard), and temporal trends of ASRs by calendar period and sex are presented by country, with the direction and magnitude of recent trends quantified using the estimated annual percentage change (EAPC).

Key findings and limitations: In 2022, an estimated 614298 new cases of bladder cancer and 220596 deaths occurred worldwide, with approximately 75% of the burden observed in males. Urothelial and squamous cell carcinomas were the predominant histological subtypes across all regions. Incidence and mortality rates varied substantially across regions and countries, with the highest rates reported in Europe, particularly in southern (ASR: 28.7) and northern (20.4) regions, and elevated rates were also seen in North America (18.0), Northern Africa (16.3), and Western Asia (15.2). Despite lower age-standardized rates, Eastern Asia reported the highest absolute numbers due to its large population. Temporal trends indicate a stabilizing or declining incidence in many high-income countries. Mortality rates have overall declined across many populations, for example, in Australia (EAPC in male: -2.6; female: -2.3), the Netherlands (male: 2.9; female: -1.6), and the USA (male: -1.3; female: -1.0). Interpretation of bladder cancer incidence patterns and trends requires caution given possible variations in cancer registration practice, notably as to whether noninvasive tumors are included in reporting.

Conclusions and clinical implications: Bladder cancer continues to pose a significant global health challenge, with marked geographic and sex-based disparities in the incidence and mortality. While encouraging declines in rates are observed in many high-income countries, the burden remains substantial in these regions and rates are rising in some settings. Tobacco smoking remains the predominant risk factor, with historical and current prevalence patterns aligned closely with disease trends. However, in Northern Africa, schistosomiasis contributes to an elevated incidence and a distinct histological profile. Interpretation of these patterns is complex given the potential variations in registration practice, with respect to reporting of noninvasive tumors.

Keywords: Bladder; Cancer; Epidemiology; Incidence; Mortality; Statistics; Trends.