Diagnosis, treatment and survival from bladder, upper urinary tract, and urethral cancers: real-world findings from NHS England between 2013 and 2019

CATTO, James W.F., MANDRIK, Olena, QUAYLE, Lewis A., HUSSAIN, Syed A., MCGRATH, John, CRESSWELL, Joanne, BIRTLE, Alison J., JONES, Rob J., MARIAPPAN, Paramananthan, MAKAROFF, Lydia E., KNIGHT, Allen, MOSTAFID, Hugh, CHILCOTT, Jim, SASIENI, Peter and CUMBERBATCH, Marcus (2023). Diagnosis, treatment and survival from bladder, upper urinary tract, and urethral cancers: real-world findings from NHS England between 2013 and 2019. BJU international, 131 (6), 734-744.

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Abstract

Objective

We report NHS England data for patients with bladder cancer (BC), upper tract urothelial cancer (UTUC: renal pelvic and ureteric), and urethral cancers from 2013 to 2019.

Materials and methods

Hospital episode statistics, waiting times, and cancer registrations were extracted from NHS Digital.

Results

Registrations included 128 823 individuals with BC, 16 018 with UTUC, and 2533 with urethral cancer. In 2019, 150 816 persons were living with a diagnosis of BC, of whom 113 067 (75.0%) were men, 85 117 (56.5%) were aged >75 years, and 95 553 (91.7%) were Caucasian. Incidence rates were stable (32.7-34.3 for BC, 3.9-4.2 for UTUC and 0.6-0.7 for urethral cancer per 100 000 population). Most patients 52 097 (mean [range] 41.3% [40.7-42.0%]) were referred outside the 2-week-wait pathway and 15 340 (mean [range] 12.2% [11.7-12.6%]) presented as emergencies. Surgery, radiotherapy, chemotherapy, or multimodal treatment use varied with disease stage, patient factors and Cancer Alliance. Between 27% and 29% (n = 6616) of muscle-invasive BCs did not receive radical treatment. Survival rates reflected stage, grade, location, and tumour histology. Overall survival rates did not improve over time (relative change: 0.97, 95% confidence interval 0.97-0.97) at 2 years in contrast to other cancers.

Conclusion

The diagnostic pathway for BC needs improvement. Increases in survival might be delivered through greater use of radical treatment. NHS Digital data offers a population-wide picture of this disease but does not allow individual outcomes to be matched with disease or patient features and key parameters can be missing or incomplete.

Item Type:	Article
Uncontrolled Keywords:	Kidney Pelvis; Humans; Carcinoma, Transitional Cell; Ureteral Neoplasms; Urethral Neoplasms; Retrospective Studies; Aged; State Medicine; Female; Male; Urinary Bladder; Urinary Bladder Neoplasms; NHS statistics; bladder cancer; cancer outcome; urothelial cell carcinoma; Female; Humans; Male; Carcinoma, Transitional Cell; Kidney Pelvis; Retrospective Studies; State Medicine; Ureteral Neoplasms; Urethral Neoplasms; Urinary Bladder; Urinary Bladder Neoplasms; Aged; 1103 Clinical Sciences; Urology & Nephrology; 3202 Clinical sciences; 3211 Oncology and carcinogenesis
Identification Number:	https://doi.org/10.1111/bju.15970
Page Range:	734-744
SWORD Depositor:	Symplectic Elements
Depositing User:	Symplectic Elements
Date Deposited:	20 Dec 2023 10:05
Last Modified:	20 Dec 2023 10:15
URI:	https://shura.shu.ac.uk/id/eprint/32901

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