Abstract

BACKGROUND:

Bladder cancer (BC) is a common genitourinary malignancy with over 80,000 new cases diagnosed annually and over 17,000 associated deaths.

OBJECTIVE:

We review 25-years of BC incidence (1993-2017) within the state of Pennsylvania to better define incidence, geographic distribution, and trends over time.

METHODS:

The Pennsylvania Cancer Registry was reviewed for statewide and component county age-adjusted BC incidence rates and stage distribution. Chloropleth maps plotting statewide and county-specific incidence rates across time were created using the GeoDa statistical package.

RESULTS:

93,476 cases of BC were recorded in Pennsylvania from 1993 to 2017. Age-adjusted annual rates of BC over the study interval were stable at 24.5 patients per 100,000 (range, 22.7–25.6). However, annual rates of distant disease increased from 0.5 to 1.1 patients per 100,000 (p < 0.001) with an average percent change increase of 6.6% over the study interval. The annual percent distribution of distant disease doubled from 2.3% to 5.1% (p < 0.001) with a greater increase in women compared to men. Chloropleth maps highlighted growing “hot spots” of bladder cancer incidence in the northwestern, northeastern, and southeastern portions of the state.

CONCLUSIONS:

While BC incidence in the state of Pennsylvania has remained relatively stable over the past 25 years, a concerning increase in distant disease was observed. Geospatial investigation implicates higher risk regions. Further studies are necessary to delineate the underlying etiologies for these observations.

中文翻译：

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在全州范围内，膀胱癌分期特定发病率的25年趋势

摘要

背景：

膀胱癌（BC）是常见的泌尿生殖系统恶性肿瘤，每年诊断出80,000多例新病例，并有17,000多例相关死亡。

目的：

我们回顾了宾夕法尼亚州25年的BC发病率（1993年至2017年），以更好地定义发病率，地理分布和一段时间内的趋势。

方法：

审查了宾夕法尼亚州癌症登记处的全州和部分县的年龄调整后的卑诗省发病率和阶段分布。使用GeoDa统计软件包创建了跨州的全州和特定县的发病率的叶绿图。

结果：

从1993年至2017年，宾夕法尼亚州记录了93,476例BC。在研究间隔中，经年龄调整的BC的年发生率稳定在每100,000例24.5例患者（22.7–25.6）。但是，每年的远距离疾病发病率从每10万人中0.5例增加到1.1例（p  <0.001），在整个研究期间平均变化百分比为6.6％。远距离疾病的年度分布百分比从2.3％翻了一番，达到5.1％（p  <0.001），女性比男性的增长更大。Chloropleth地图突出显示了该州西北部，东北部和东南部越来越多的膀胱癌发病率“热点”。

结论：

尽管宾夕法尼亚州的BC发病率在过去25年中一直保持相对稳定，但远处疾病却出现了令人担忧的增加。地理空间调查牵涉到较高风险的区域。有必要进行进一步的研究来描述这些观察的潜在病因。