World Journal of Urology

, Volume 29, Issue 4, pp 457–463 | Cite as

Impact of gender on bladder cancer incidence, staging, and prognosis

  • Harun Fajkovic
  • Joshua A. Halpern
  • Eugene K. Cha
  • Atessa Bahadori
  • Thomas F. Chromecki
  • Pierre I. Karakiewicz
  • Eckart Breinl
  • Axel S Merseburger
  • Shahrokh F. Shariat
Topic Paper

Abstract

Introduction

While patient gender is an important factor in the clinical decision-making for the management of bladder cancer, there are minimal evidence-based recommendations to guide health care professionals. Recent epidemiologic and translational research has shed some light on the complex relationship between gender and bladder cancer. Our aim was to review the literature on the effect of gender on bladder cancer incidence, biology, mortality, and treatment.

Methods

Using MEDLINE, we performed a search of the literature between January 1975 and April 2011.

Results

Although men are nearly 3–4 times more likely to develop bladder cancer than women, women present with more advanced disease and have worse survival. Recently, a number of population-based and multicenter collaborative studies have shown that female gender is associated with a significantly higher rate of cancer-specific recurrence and mortality after radical cystectomy. The disparity between genders is proposed to be the result of a differences exposure to carcinogens (i.e., tobacco and chemicals) as well as reflective of genetic, anatomic, hormonal, societal, and environmental factors. Explanations for the differential behavior of bladder cancer between genders include sex steroids and their receptors as well as inferior quality of care for women (inpatient length of stay, referral patterns, and surgical outcomes).

Conclusions

It is imperative that health care practitioners and researchers from disparate disciplines collectively focus efforts to appropriately develop gender-specific evidence-based guidelines for bladder cancer patients. We must strive to develop multidisciplinary collaborative efforts to provide tailored gender-specific care for bladder cancer patients.

Keywords

Female Male Gender Recurrence Survival Bladder cancer prognosis Urothelial carcinoma 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Harun Fajkovic
    • 1
    • 2
  • Joshua A. Halpern
    • 1
  • Eugene K. Cha
    • 1
  • Atessa Bahadori
    • 1
  • Thomas F. Chromecki
    • 1
    • 3
  • Pierre I. Karakiewicz
    • 4
  • Eckart Breinl
    • 2
  • Axel S Merseburger
    • 5
  • Shahrokh F. Shariat
    • 1
  1. 1.Department of Urology and Division of Medical Oncology, Weill Cornell Medical CollegeNew York-Presbyterian HospitalNew YorkUSA
  2. 2.Landesklinikum St. PoeltenSankt PoeltenAustria
  3. 3.Medical University of GrazGrazAustria
  4. 4.University of MontréalMontréalCanada
  5. 5.Department of UrologyHannover Medical SchoolHannoverGermany

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