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Urological cancers impose huge burden to our healthcare system, and the problem has become increasingly important in the aging society [1,2,3,4]. prevention is always better than cure, and to achieve this, we must understand the epidemiology and risk factors of urological cancers.
Apart from smoking, environmental factors such as aristolochic acid-containing Chinese herbal medicine play a significant role in upper tract urothelial carcinoma. The review article by Dickman et al. [5] explains the potential underlying mechanisms and its association with the exceptionally high incidence of upper tract urothelial carcinoma in Taiwan.
In the meta-analysis by Mori et al. [6], it was found that female patients with muscle-invasive bladder cancer had worse survival outcomes than male patients. While sex is not a modifiable factor, this article certainly highlights the possible role of genetic, social and even hormonal factors in the disease course of bladder cancer.
When urological cancers are not avoidable, early detection can still render a cure and reduce cancer-related mortality. While resources are limited, it is important to adopt wise and cost-effectiveness screening methods for urological cancers.
Magnetic resonance imaging (MRI) has been investigated as a screening tool for prostate cancer. Preliminary results are favoring the ‘MRI-only’ approach, however, MRI-based prostate cancer screening still faces a variety of obstacles that remain to be addressed. The current data and the obstacles that have to be overcome are nicely summarized by the review paper by Würnschimmel et al. [7].
Renal cell carcinoma classically presents with the triad of hematuria, flank pain and flank mass. However, this would represent a rather late-stage disease, and nowadays renal tumors are more commonly discovered incidentally upon imaging. In the paper by Diana et al. [8], the authors discussed about the current evidence on screening programs for renal cell carcinoma, and discussed whether such approach is feasible in a population-based setting.
For testicular cancers, patients mostly present with scrotal masses. While testicular self-examination does not carry any costs, public awareness and knowledge on such maneuver are very limited. In the paper by Chong et al. [9], the authors summarized the current evidence on testicular self-examination for early detection testicular cancer.
I hope you would enjoy this topic issue on “Epidemiology and screening for urologic cancers”. The articles have no doubt provided important insights regarding the prevention and early diagnosis of urological cancers. Fighting urological cancers is never an easy journey. Slowly but steadily, we will conquer!
References
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Teoh, J.YC. Epidemiology and screening for urologic cancers. World J Urol 41, 897–898 (2023). https://doi.org/10.1007/s00345-023-04405-z
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DOI: https://doi.org/10.1007/s00345-023-04405-z