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The epidemiology of bladder and kidney cancer

Abstract

Bladder and kidney cancer together account for about 5% of cancers worldwide, and represent the 9th and 14th most common cancers in terms of absolute numbers, respectively. Our knowledge of these two cancers, however, indicates that they have strikingly different etiology. A number of important occupational, lifestyle and genetic factors have been implicated in bladder carcinogenesis, which have greatly increased our understanding of this disease. In some instances, identification of these factors has contributed to the prevention or reduction of exposure to bladder carcinogens. Conversely, the etiology of kidney cancer is less well elucidated, which limits the possibilities for reducing its incidence by this approach. It is likely that much remains to be uncovered about the causes of these two cancers, and these advances will increase our appreciation of the biology of these cancers and perhaps lead to further possibilities for their prevention. In this article, we evaluate the epidemiology of bladder and kidney cancer and also discuss potential priorities for future research.

Key Points

  • Populations with a high incidence of bladder cancer include the Mediterranean countries of Europe and Egypt, whereas populations with a high incidence of kidney cancer include central Europe and the black population of the US

  • Improved survival for both bladder and kidney cancer is associated with a young age at diagnosis and also differs between countries; geographical differences are particularly apparent for kidney cancer

  • Tobacco smoking is the most important risk factor for bladder cancer; occupational exposure to aromatic amines and infection with Schistosoma hematobium are also important recognized risk factors

  • Tobacco smoking is also a recognized risk factor for kidney cancer, as are obesity and hypertension

  • Genetic variants of GSTM1 and NAT2 influence bladder cancer risk, and NAT2 variants interact with smoking status to exacerbate bladder cancer risk

  • Apart from rare, high-risk genetic variants, susceptibility genes for kidney cancer are yet to be discovered

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Figure 1: 5-year relative survival for bladder and kidney cancers
Figure 2: Observed survival for bladder and kidney cancers diagnosed in 1998 in the US
Figure 3: World maps that show geographical variations in annual bladder and kidney cancer incidence rates, in numbers of cases per 100,000 of the population, standardized for age against the world population
Figure 4: Life cycle of Schistosoma

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Acknowledgements

G Scélo worked on this manuscript during her tenure of a Special Training Award from the International Agency for Research on Cancer.

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Correspondence to Paul Brennan.

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Scélo, G., Brennan, P. The epidemiology of bladder and kidney cancer. Nat Rev Urol 4, 205–217 (2007). https://doi.org/10.1038/ncpuro0760

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