Gender Differences Found in Bladder Cancer Treatment, Survival
Men receive more aggressive treatment for muscle-invasive urinary bladder cancer than women in Sweden.
SAN DIEGO—Men receive more aggressive treatment for muscle-invasive urinary bladder cancer (UBC) than women in Sweden, according to new research presented at the American Urological Association 2016 annual meeting.
The Swedish National Registry of Urinary Bladder Cancer (SNRUBC) captures almost all patients in that country diagnosed with UBC. A team led by Andreas Thorstenson, MD, PhD, of Capio St Göran's Hospital in Stockholm, decided to examine trends in UBC treatment and survival with special attention to gender. During 1997 to 2011, there were 30,310 patients: 74.9% male and 25.1% female.
Results showed that women had a higher rate of aggressive tumors, but fewer of them received optimal treatment. More women than men had stage T2–T4 cancer and grade 1 tumors. A larger percentage of men with stage T2–T4, however, underwent radical cystectomy (37.6% vs 32.6%). Similarly, more men with carcinoma in situ (CIS) or T1G3 received intravesical Bacillus Calmette-Guérin (BCG) or intravesical chemotherapy.
The investigators also found that women had worse survival. Cancer-specific survival at 5 years was 76.9% for men and 71.5% for women, and overall survival at 5 years was 72.3% for men and 69.3% for women.
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“In our society, it is taken for granted that men and women have equal access to cancer treatments,” Dr Thorstenson told Renal & Urology News. “However, fewer Swedish women receive BCG or radical cystectomy for bladder cancer. The women also have inferior cancer-specific survival. We hope that there are factors other than gender influencing the results.”