The effect of age and gender on bladder cancer: A critical review of the literature Journal Article

Authors: Shariat, S. F.; Sfakianos, J. P.; Droller, M. J.; Karakiewicz, P. I.; Meryn, S.; Bochner, B. H.
Article Title: The effect of age and gender on bladder cancer: A critical review of the literature
Abstract: While patient age and gender are important factors in the clinical decision-making for treating urothelial carcinoma of the bladder (UCB), there are no evidence-based recommendations to guide healthcare professionals. We review previous reports on the influence of age and gender on the incidence, biology, mortality and treatment of UCB. Using MEDLINE, we searched for previous reports published between January 1966 and July 2009. While men are three to four times more likely to develop UCB than women, women present with more advanced disease and have worse survival rates. The disparity among genders is proposed to be the result of a differential exposure to carcinogens (i.e. tobacco and chemicals) as well as reflecting genetic, anatomical, hormonal, societal and environmental factors. Inpatient length of stay, referral patterns for haematuria and surgical outcomes suggest that inferior quality of care for women might be an additional cause of gender inequalities. Age is the greatest single risk factor for developing UCB and dying from it once diagnosed. Elderly patients face both clinical and institutional barriers to appropriate treatment; they receive less aggressive treatment and sub-therapeutic dosing. Much evidence suggests that chronological age alone is an inadequate indicator in determining the clinical and behavioural response of older patients to UCB and its treatment. Epidemiological and mechanistic molecular studies should be encouraged to design, analyse and report gender-and age-specific associations. Improved bladder cancer awareness in the lay and medical communities, careful patient selection, treatment tailored to the needs and the physiological and physical reserve of the individual patient, and proactive postoperative care are particularly important. We must strive to develop transdisciplinary collaborative efforts to provide tailored gender-and age-specific care for patients with UCB. © 2009 BJU International.
Keywords: survival; adult; cancer survival; aged; aged, 80 and over; middle aged; surgical technique; survival rate; interferon; cancer risk; patient selection; antineoplastic agents; postoperative care; chemotherapy; outcome assessment; cancer incidence; bcg vaccine; metastasis; quality of life; recurrence; age factors; bladder cancer; risk factor; urinary bladder neoplasms; hematuria; cancer mortality; age; fever; health care quality; length of stay; immunotherapy; cystectomy; urinary diversion; urothelial carcinoma; medline; short survey; behavior; sex difference; tobacco; sex factors; gender; environmental factor; elderly; patient referral; carcinogen; micturition disorder; chemical agent; age specific care; health care need; urinary dysfunction
Journal Title: BJU International
Volume: 105
Issue: 3
ISSN: 1464-4096
Publisher: Wiley Blackwell  
Date Published: 2010-02-01
Start Page: 300
End Page: 308
Language: English
DOI: 10.1111/j.1464-410X.2009.09076.x
PUBMED: 19912200
PROVIDER: scopus
PMCID: PMC4315315
Notes: --- - "Cited By (since 1996): 7" - "Export Date: 20 April 2011" - "CODEN: BJINF" - "Source: Scopus"
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MSK Authors
  1. Shahrokh Shariat
    67 Shariat
  2. Bernard Bochner
    324 Bochner