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Bilski K, Żeber-Lubecka N, Kulecka M, Dąbrowska M, Bałabas A, Ostrowski J, Dobruch A, Dobruch J. Microbiome Sex-Related Diversity in Non-Muscle-Invasive Urothelial Bladder Cancer. Curr Issues Mol Biol 2024; 46:3595-3609. [PMID: 38666955 PMCID: PMC11048804 DOI: 10.3390/cimb46040225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Sex-specific discrepancies in bladder cancer (BCa) are reported, and new studies imply that microbiome may partially explain the diversity. We aim to provide characterization of the bladder microbiome in both sexes diagnosed with non-muscle-invasive BCa with specific insight into cancer grade. In our study, 16S rRNA next-generation sequencing was performed on midstream urine, bladder tumor sample, and healthy-appearing bladder mucosa. Bacterial DNA was isolated using QIAamp Viral RNA Mini Kit. Metagenomic analysis was performed using hypervariable fragments of the 16S rRNA gene on Ion Torrent Personal Genome Machine platform. Of 41 sample triplets, 2153 taxa were discovered: 1739 in tumor samples, 1801 in healthy-appearing bladder mucosa and 1370 in midstream urine. Women were found to have smaller taxa richness in Chao1 index than men (p = 0.03). In comparison to low-grade tumors, patients with high-grade lesions had lower bacterial diversity and richness in urine. Significant differences between sexes in relative abundance of communities at family level were only observed in high-grade tumors.
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Affiliation(s)
- Konrad Bilski
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Prof. W. Orlowski, 00-416 Warsaw, Poland;
| | - Natalia Żeber-Lubecka
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre for Postgraduate Medical Education, 02-781 Warsaw, Poland; (N.Ż.-L.); (M.K.); (J.O.)
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.); (A.B.)
| | - Maria Kulecka
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre for Postgraduate Medical Education, 02-781 Warsaw, Poland; (N.Ż.-L.); (M.K.); (J.O.)
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.); (A.B.)
| | - Michalina Dąbrowska
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.); (A.B.)
| | - Aneta Bałabas
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.); (A.B.)
| | - Jerzy Ostrowski
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre for Postgraduate Medical Education, 02-781 Warsaw, Poland; (N.Ż.-L.); (M.K.); (J.O.)
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (M.D.); (A.B.)
| | | | - Jakub Dobruch
- Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Prof. W. Orlowski, 00-416 Warsaw, Poland;
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Rasti A, Abazari O, Dayati P, Kardan Z, Salari A, Khalili M, Motlagh FM, Modarressi MH. Identification of Potential Key Genes Linked to Gender Differences in Bladder Cancer Based on Gene Expression Omnibus (GEO) Database. Adv Biomed Res 2023; 12:157. [PMID: 37564439 PMCID: PMC10410418 DOI: 10.4103/abr.abr_280_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/05/2022] [Accepted: 11/14/2022] [Indexed: 08/12/2023] Open
Abstract
Background Growing evidence strongly indicates pivotal roles of gender differences in the occurrence and survival rate of patients with bladder cancer, with a higher incidence in males and poorer prognosis in females. Nevertheless, the molecular basis underlying gender-specific differences in bladder cancer remains unknown. The current study has tried to detect key genes contributing to gender differences in bladder cancer patients. Materials and Methods The gene expression profile of GSE13507 was firstly obtained from the Gene Expression Omnibus (GEO) database. Further, differentially expressed genes (DEGs) were screened between males and females using R software. Protein-protein interactive (PPI) network analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO), and Kaplan-Meier survival analyses were also performed. Results We detected six hub genes contributing to gender differences in bladder cancer patients, containing IGF2, CCL5, ASPM, CDC20, BUB1B, and CCNB1. Our analyses demonstrated that CCNB1 and BUB1B were upregulated in tumor tissues of female subjects with bladder cancer. Other genes, such as IGF2 and CCL5, were associated with a poor outcome in male patients with bladder cancer. Additionally, three signaling pathways (focal adhesion, rheumatoid arthritis, and human T-cell leukemia virus infection) were identified to be differentially downregulated in bladder cancer versus normal samples in both genders. Conclusion Our findings suggested that gender differences may modulate the expression of key genes that contributed to bladder cancer occurrence and prognosis.
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Affiliation(s)
- Azam Rasti
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Abazari
- Department of Clinical Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Parisa Dayati
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zahra Kardan
- Department of Cellular Molecular Biology, Faculty of Life Science and Biotechnology, Shahid Beheshti University, Tehran
- Systems Biology Research Lab, Bioinformatics Group, Systems Biology of the Next Generation Company (SBNGC), Qom, Iran
| | - Ali Salari
- Systems Biology Research Lab, Bioinformatics Group, Systems Biology of the Next Generation Company (SBNGC), Qom, Iran
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran
- Salari Institute of Cognitive and Behavioral Disorders (SICBD), Karaj, Alborz, Iran
| | - Masoud Khalili
- Department of Urology, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Movahedi Motlagh
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Al-Ani A, Amarin JZ, Al-Huneidy L, Al-Hussaini M. Sex differences in cancer incidence and mortality among patients managed at King Hussein Cancer Center. Int J Cancer 2022; 151:1960-1968. [PMID: 35830208 DOI: 10.1002/ijc.34213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 11/08/2022]
Abstract
We investigated if female survival advantage trends in cancer are consistent within Jordanian patients with cancer across different age groups and non-sex specific cancer types. We explored the King Hussein Cancer Center registry for primary malignant tumors from 2006 to 2019. The registry (n = 16,454) was stratified into three groups based on age: children (<15 years), adolescents and young adults (AYA) (modified; 15 - 49 years), and older adults (≥50 years). Kaplan-Meier analysis was used to estimate the 5-year all-site cancer-specific survival probabilities, which were compared using the log-rank test by sex and age group. Out of 16,454 eligible records, 2286 (13.9%) were children, 5975 (36.3%) were AYAs, and 8193 (49.8%) were older adults. Males outnumbered females 10,339 (62.8%) to 6115 (37.2%). The 5-year OS rates were 74.0% (71.6%-76.4%) and 72.7% (69.9%-75.5%) for pediatric males and females, respectively, 57.3% (55.6%-59.0%) and 64.5% (62.6%-66.4%) for male and female AYAs, respectively, and 37.5% (36.2%-38.9%) and 44.2% (42.3%-46.2%) for older adult males and females, respectively. Females demonstrated significantly better overall survival in the AYA and older adults' groups. In conclusion, females exhibit a survival advantage in terms of non-sex specific cancers. This advantage peaks at the AYA age stratum and mitigates thereafter. Further studies are warranted to examine the etiological factors behind such discrepancy on a site-by-site basis so that sex-specific interventions can be designed and validated. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| | - Justin Z Amarin
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman, Jordan
| | | | - Maysa Al-Hussaini
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
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Joshi M, Polimera H, Krupski T, Necchi A. Geography Should Not Be an "Oncologic Destiny" for Urothelial Cancer: Improving Access to Care by Removing Local, Regional, and International Barriers. Am Soc Clin Oncol Educ Book 2022; 42:1-14. [PMID: 35471833 DOI: 10.1200/edbk_350478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Urothelial cancer care is particularly susceptible to geographical health disparity given its complex nature, requiring access to several specialists such as a urologist, a medical oncologist, a radiation oncologist, a surgical oncologist, and multidisciplinary care teams. Furthermore, other barriers to care access in underserved areas include travel burden, longer wait times, late-stage disease at the time of diagnosis, cost, type of treatment, less enrollment in clinical trials, lack of follow-up among cancer survivors, and less research funding in this area. Here, we discuss the impact of geographical location on access to urothelial cancer care, management decisions, and outcomes and we reflect on how to address geographical disparities in care delivery.
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Affiliation(s)
- Monika Joshi
- Division of Hematology-Oncology, Department of Medicine, Penn State Cancer Institute, Hershey, PA
| | - Hyma Polimera
- Division of Hematology-Oncology, Department of Medicine, Penn State Cancer Institute, Hershey, PA
| | - Tracey Krupski
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Andrea Necchi
- Vita-Salute San Raffaele University, Milan, Italy.,IRCCS Ospedale San Raffaele, Milan, Italy
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Alqahtani MA, Alghafees MA, Musalli ZF, Alwatban SM, Alasker A. Rare tumours of the bladder: A Saudi registry based descriptive study. J Taibah Univ Med Sci 2022; 17:573-577. [PMID: 35983444 PMCID: PMC9356363 DOI: 10.1016/j.jtumed.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 11/30/2022] Open
Abstract
Objective There is limited literature focusing on the characteristics and behaviours of bladder tumours outside of the common three morphologies, that is, urothelial carcinoma, squamous cell carcinoma, and adenocarcinoma. The presented study provides a descriptive analysis of rare bladder tumours in KSA. Methods This retrospective cohort study included all patients with a primary rare bladder tumour between 1 January 2008 and 31 December 2017. The data were acquired from the Saudi Tumour Registry. Frequencies and percentages were then generated for the categorical variables, while means and standard deviations were calculated for quantitative variables. Results The study included 65 patients. The majority (n = 35, 53.8%) were aged 60 years and older. The patients were predominantly male (n = 53, 81.5%) and the majority lived in the Western region (n = 26, 40.?%). The most diagnosed tumour morphologies were small cell carcinoma in adults (n = 11, 16.9%) and embryonal rhabdomyosarcoma in children (n = 14, 21.5%), with the dominant diagnosis method being histology of primary tumour in 98.5% of the patients. Most tumours were localised (n = 30, 46.2%) and multifocal (n = 34, 52.3%). The overall mortality rate was 24.6%, with an overall diagnosis to death interval of 1.14 ± 0.75 years wherein small cell carcinoma was the shortest (0.84 ± 0.24) days. Conclusion There remains a gap in the literature regarding uncommon urologic tumours. Shedding light on these factors will aid in further understanding the patterns of tumour behaviour in the region. This will facilitate enhanced risk-and response-based screening strategies and more favourable outcomes. Additionally, formulating a global registry for such patients is recommended.
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Affiliation(s)
- Meshari A. Alqahtani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
| | - Mohammad A. Alghafees
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
- Corresponding address: College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Uzzam, AlManar, Riyadh, 14222, KSA.
| | - Ziyad F. Musalli
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
| | - Saud M. Alwatban
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
| | - Ahmed Alasker
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA
- King Abdullah International Medical Research Center, Riyadh, KSA
- Department of Urology, King Abdulaziz Medical City, Riyadh, KSA
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Zimmermann K, Mostafaei H, Heidenreich A, Schmelz HU, Shariat SF, Mori K. Health-related quality of life in bladder cancer patients: general and cancer-specific instruments. Part 1. Curr Opin Urol 2021; 31:297-303. [PMID: 33965980 DOI: 10.1097/mou.0000000000000893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW Although survival outcomes are the primary outcomes to determine the effectiveness of treatment options, quality of life (QoL) is gaining in importance in addition to classic oncological outcomes. The present review aims to state and critically assess the challenges in health-related QoL (HRQoL) assessment especially in bladder cancer (BC) patients. RECENT FINDINGS General QoL-instruments do not address concerns specific to cancer patients or BC patients. Domains, such as sexual functioning, embarrassment, self-consciousness, psychological distress, and urinary incontinence, are not adequately covered by any of the available instruments. With these QoL-instruments becoming increasingly specialized, the general aspects of QoL and possible unanticipated adverse effects are no longer likely to be accurately assessed. Sex-specific requirements have not been properly addressed by these QoL-instruments. HRQoL is reported to be lower in the elderly population, which may be due to their associated comorbidities and limitations, rather than treatment-related issues. SUMMARY Due to their specifications, BC-specific instruments need to be used together with general QoL instruments to assess overall well being and disease- and treatment-specific QoL. Assessment of age-specific HRQoL is essential to understanding the QoL burden in each age group. QoL assessment calls for more detailed sex-specific questions to accurately address the HRQoL dimensions in men and women alike.
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Affiliation(s)
- Kristin Zimmermann
- Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz, Germany
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Axel Heidenreich
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, Uro-Oncology, Robot-Assisted and Specialized Urologic Surgery, University Hospital Cologne, Cologne, Germany
| | - Hans U Schmelz
- Department of Urology, Federal Armed Services Hospital Koblenz, Koblenz, Germany
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Urology, Weill Cornell Medical College, New York, New York, USA
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
- Department of Urology, University of Jordan, Amman, Jordan
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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Wang W, Liu J, Liu L. Development and Validation of a Prognostic Model for Predicting Overall Survival in Patients With Bladder Cancer: A SEER-Based Study. Front Oncol 2021; 11:692728. [PMID: 34222021 PMCID: PMC8247910 DOI: 10.3389/fonc.2021.692728] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 05/17/2021] [Indexed: 12/24/2022] Open
Abstract
Objective To establish a prognostic model for Bladder cancer (BLCA) based on demographic information, the American Joint Commission on Cancer (AJCC) 7th staging system, and additional treatment using the surveillance, epidemiology, and end results (SEER) database. Methods Cases with BLCA diagnosed from 2010–2015 were collected from the SEER database, while patient records with incomplete information on pre-specified variables were excluded. All eligible cases were included in the full analysis set, which was then split into training set and test set with a 1:1 ratio. Univariate and multivariate Cox regression analyses were conducted to identify prognostic factors for overall survival (OS) in BLCA patients. With selected independent prognosticators, a nomogram was mapped to predict OS for BLCA. The nomogram was evaluated using receiver operating characteristic (ROC) analysis and calibration plot in both the training and test sets. The area under curve [AUC] of the nomogram was calculated and compared with clinicopathological indicators using the full analysis set. Statistical analyses were conducted using the R software, where P-value <0.05 was considered significant. Results The results indicated that age, race, sex, marital status, histology, tumor-node-metastasis (TNM) stages based on the AJCC 7th edition, and additional chemotherapy were independent prognostic factors for OS in patients with BLCA. Patients receiving chemotherapy tend to have better survival outcomes than those without. The proposed nomogram showed decent classification (AUCs >0.8) and prediction accuracy in both the training and test sets. Additionally, the AUC of the nomogram was observed to be better than that of conventional clinical indicators. Conclusions The proposed nomogram incorporated independent prognostic factors including age, race, sex, marital status, histology, tumor-node-metastasis (TNM) stages, and additional chemotherapy. Patients with BLCA benefit from chemotherapy on overall survival. The nomogram-based prognostic model could predict overall survival for patients with BLCA with accurate stratification, which is superior to clinicopathological factors.
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Affiliation(s)
- Wei Wang
- Institute of Military Hospital Management, The Chinese PLA General Hospital, Beijing, China.,Department of Rehabilitation Medicine, Qingdao Special Servicemen Recuperation Center of People's Liberation Army (PLA) Navy, Qingdao, China
| | - Jianchao Liu
- Institute of Military Hospital Management, The Chinese PLA General Hospital, Beijing, China
| | - Lihua Liu
- Institute of Military Hospital Management, The Chinese PLA General Hospital, Beijing, China
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Huang CY, Wang SC, Chan L, Hsieh TY, Sung WW, Chen SL. Gender differences in trends of bladder cancer mortality-to-incidence ratios according to health expenditure in 55 countries. PLoS One 2021; 16:e0244510. [PMID: 33577604 PMCID: PMC7880433 DOI: 10.1371/journal.pone.0244510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/10/2020] [Indexed: 12/24/2022] Open
Abstract
The association between bladder cancer mortality-to-incidence ratios (MIRs) and healthcare disparities has gender differences. However, no evidence supports gender as an issue in the association between changes in the MIR and health expenditures on bladder cancer. Changes in the MIR were defined as the difference in data from the years 2012 and 2018, which was named δMIR. Current health expenditures (CHE) and the human development index (HDI) were obtained from the World Health Organization and the Human Development Report Office. The association between variables was analyzed by Spearman’s rank correlation coefficient. In total, 55 countries were analyzed according to data quality and the exclusion of missing data. Globally, the MIR changed according to the HDI level in both genders. Among the 55 countries studied, a high HDI and CHE were significantly associated with a favorable age-standardized rate-based MIR (ASR-based MIR) in both genders and the subgroups according to gender (for both genders, MIR vs. HDI: ρ = -0.720, p < 0.001; MIR vs. CHE per capita: ρ = -0.760, p < 0.001; MIR vs. CHE as a percentage of gross domestic product (CHE/GDP): ρ = -0.663, p < 0.001). Importantly, in females only, the CHE/GDP but neither the HDI score nor the CHE per capita was significantly associated with a favorable ASR-based δMIR (ASR-based δMIR vs. CHE/GDP: ρ = 0.414, p = 0.002). In the gender subgroups, the association between the HDI and the CHE was statistically significant for females and less significant for males. In conclusion, favorable bladder ASR-based MIRs were associated with a high CHE; however, improvement of the ASR-based δMIR data was more correlated with the CHE in females. Further investigation of the gender differences via a cohort survey with detailed information of clinical-pathological characteristics, treatment strategies, and outcomes might clarify these issues and improve therapeutic and/or screening strategies for bladder cancer.
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Affiliation(s)
- Cheng-Yu Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Shao-Chuan Wang
- Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Lung Chan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tzuo-Yi Hsieh
- Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wen-Wei Sung
- Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- * E-mail: (WWS); (SLC)
| | - Sung-Lang Chen
- Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- * E-mail: (WWS); (SLC)
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Moorthy HK, Prabhu GGL, Venugopal P. Clinical and therapeutic implications of sex steroid hormone receptor status in urothelial bladder cancer. Indian J Urol 2020; 36:171-178. [PMID: 33082631 PMCID: PMC7531383 DOI: 10.4103/iju.iju_320_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/02/2020] [Accepted: 03/31/2020] [Indexed: 12/24/2022] Open
Abstract
Studies on the clinical profile of urothelial bladder cancer (UBC) have shown significant gender differences, namely, higher occurrence in males (male-to-female ratio of 3.5:1) and an advanced stage of disease at the time of diagnosis with rapid progression of the disease after initial diagnosis seen more commonly in females. The relationship between gender and UBC is complex and probably influenced by biological and epidemiological factors. Potential contributory factors such as sex steroid hormone pathway, gender difference in environmental carcinogen exposure, metabolic enzyme activity, and disparities in the intensity of diagnostic evaluation could probably explain the demographic trends in UBC. This comprehensive review of Medline publications during the period 2009–2019 attempts to identify the possible role of sex hormone receptors in gender variation and sexual dimorphism in the occurrence and progression of UBC. The clinical implications of identifying sex steroid receptors on factors such as disease prognostication and the therapeutic role of anti-androgens in the prevention and progression of UBC are critically reviewed. There is now significant evidence in literature to suggest the possible role of sex steroid hormone receptor-mediated signals in the genesis and progression of UBC. These receptors include androgen receptors, estrogen receptors, progesterone receptors, and various other orphan receptors. Excessive or reduced expression of these receptors, as well as alterations in their upstream or downstream pathways, correlate well with the clinical and therapeutic outcomes of UBC.
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Affiliation(s)
| | - G G Laxman Prabhu
- Department of Urology, Kasturba Medical College (A Unit of Manipal Academy of Higher Education), Mangalore, Karnataka, India
| | - P Venugopal
- Department of Urology, Kasturba Medical College (A Unit of Manipal Academy of Higher Education), Mangalore, Karnataka, India
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The global burden of urinary bladder cancer: an update. World J Urol 2019; 38:1895-1904. [PMID: 31676912 PMCID: PMC7363726 DOI: 10.1007/s00345-019-02984-4] [Citation(s) in RCA: 451] [Impact Index Per Article: 90.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/17/2019] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer is among the top ten most common cancer types in the world, with approximately 550,000 new cases annually. The highest burden of bladder cancer is currently falling on most developed communities across the globe. But with an anticipated shift in world demographics with growing and aging populations mainly on the African continent, and important shifts in exposure to different risk factors across the world, this is likely to change over the next decades. In this review, we provide an overview of the current incidence, mortality, prevalence, survival, risk factors and costs of bladder cancer worldwide.
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Zhou Y, Funston G, Lyratzopoulos G, Walter FM. Improving the Timely Detection of Bladder and Kidney Cancer in Primary Care. Adv Ther 2019; 36:1778-1785. [PMID: 31102201 PMCID: PMC6602991 DOI: 10.1007/s12325-019-00966-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Indexed: 12/13/2022]
Abstract
Bladder and kidney cancer are the 10th and 7th most common cancers in the United Kingdom (UK). They present with symptoms that are typically investigated via the same diagnostic pathway. However, diagnosing these cancers can be challenging, especially for kidney cancer, as many of the symptoms are non-specific and occur commonly in patients without cancer. Furthermore, the recognition and evaluation of these symptoms may differ because of the lack of supporting high-quality evidence to inform management, a problem also reflected in currently ambiguous guidelines. The majority of these two cancers are diagnosed following a referral from a general practitioner. In this article, we summarise current UK and United States (US) guidelines for investigating common symptoms of bladder and kidney cancer-visible haematuria, non-visible haematuria and urinary tract infections. Our article aims to support clinicians in recognising and investigating patients with symptoms of possible bladder and kidney cancer in a timely fashion. We discuss challenges during the diagnostic process and possible future interventions for improvement.
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Affiliation(s)
- Yin Zhou
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Garth Funston
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Georgios Lyratzopoulos
- ECHO (Epidemiology of Cancer Healthcare and Outcomes) Research Group, Department of Behavioural Science and Health, University College London, London, UK
| | - Fiona M Walter
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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