Survival in bladder and upper urinary tract cancers in Finland and Sweden through 50 years

Abstract

Survival has improved in bladder cancer but few studies have considered extended periods or covered populations for which medical care is essentially free of charge. We analyzed survival in urothelial cancer (UC, of which vast majority are bladder cancers) in Finland and Sweden over a 50-year period (1967–2016) using data from the NORDCAN database. Finland and Sweden are neighboring countries with largely similar health care systems but higher economic resources and health care expenditure in Sweden. We present results on 1- and 5-year relative survival rates, and additionally provide a novel measure, the difference between 1- and 5-year relative survival, indicating how well survival was maintained between these two periods. Over the 50-year period the median diagnostic age has increased by several years and the incidence in the very old patients has increased vastly. Relative 1- year survival rates increased until early 1990s in both countries, and with minor gains later reaching about 90% in men and 85% in women. Although 5-year survival also developed favorably until early 1990s, subsequent gains were small. Over time, age specific differences in male 1-year survival narrowed but remained wide in 5-year survival. For women, age differences were larger than for men. The limitations of the study were lack of information on treatment and stage. In conclusion, challenges are to improve 5-year survival, to reduce the gender gap and to target specific care to the most common patient group, those of 70 years at diagnosis. The most effective methods to achieve survival gains are to target control of tobacco use, emphasis on early diagnosis with prompt action at hematuria, upfront curative treatment and awareness of high relapse requiring regular cystoscopy follow up.

Survival in Kidney and Bladder Cancers in Four Nordic Countries through a Half Century

“…A sex difference has been known to exist in bladder cancer survival, and many explanations have been brought forward [20]. In the present 5-year survival, the sex difference was 5.5% units for male advantage.…”

“…Nonmuscle invasive (superficial) tumors require surveillance, as there is a risk of later recurrence or progression [19]. Survival in bladder cancer has developed well, and the likely reasons are early detection, thanks to novel imaging technologies and better cystoscopy equipment, and improvements in treatment [18,20].…”

Survival in gastric and esophageal cancers in the Nordic countries through a half century

“…The difference between years 1 and 5 survival has been recently reported in several cancers from FI and SE. In both countries, survival difference decreased with time for bladder cancer and for renal cell cancer in FI only 19,24 . For colorectal cancer, the difference narrowed over time for rectal cancer but for colon cancer, it remained constant 18 .…”

“…In both countries, survival difference decreased with time for bladder cancer and for renal cell cancer in FI only. 19 , 24 For colorectal cancer, the difference narrowed over time for rectal cancer but for colon cancer, it remained constant. 18 We assume that survival improvement between years 1 and 5 is likely to indicate earlier diagnosis and true treatment benefits in at least locally advanced tumors, as in rectal cancer surgery and radiotherapy have improved late survival.…”

Long-term survival trends for primary liver and pancreatic cancers in the Nordic countries

“…In our previous studies on colorectal and urological cancers, the difference between 1- and 5-year survival either declined or modestly increased with time, in contrast to the present results. 22 , 28 , 29 The large increase in the difference may suggest that improvements in earlier diagnosis, treatments, and care helped, increasing numbers of patients survive past Year 1, but lack of curative treatment options resulted in death before 5 years. Also, increasing numbers of liver transplantations have first influenced 1-year survival and with aging patients will increase 5-year survival.…”