ABSTRACT
BACKGROUND: Urothelial carcinoma of the urinary bladder (UCB) is the 4th most common cancer type in men in developed countries, and tumor recurrence or progression occurs in more than half of the patients. Previous studies report contradictory trends in incidence and survival over the past decades. This article describes the trends of UCB incidence and survival from 1981 to 2014, including both invasive and non-invasive UCB using data from the Cancer Registry of Norway. METHODS: In Norway, 33,761 patients were diagnosed with UCB between 1981 and 2014. Incidence and 5-year relative survival were calculated, stratified by sex, morphology, stage, age and diagnostic period. Age-period-cohort models were used to distinguish period- and cohort effects. Temporal trends were summarized by calculating the average absolute annual change in incidence and relative survival allowing for breaks in this trend by incorporating a joinpoint analysis. Excess mortality rate ratios (EMRR) quantify the relative risks by using a proportional excess hazard model. RESULTS: The incidence of UCB in men increased from 18.5 (1981-85) to 21.1 (1991-95) per 100 000 person-years and was rather stable thereafter (1996-2014). The incidence rates of UCB were lower in women increasing linearly from 4.7 to 6.2 over the past 34 years (p = 5.9 · 10-7). These trends could be explained by an increase of the incidence rates of non-invasive tumors. Furthermore, the observed pattern seemed to represent a birth cohort effect. Five-year relative survival increased annually with 0.004 in men (p = 1.3 · 10-6) and 0.003 in women (p = 4.5 · 10-6). There is a significant increase over the past 34 years in survival of UCB in both genders for local tumors but not for advanced stages. CONCLUSIONS: Increasing and stable incidence trends mirror little improvement in primary and secondary prevention of UCB for more than three decades. Survival proportions increased only marginally. Thus, any changes in treatment and follow-up care did not lead to notable improvement with respect to survival of the patients. High estimates of preventable cases together with large recurrence rates of this particular cancer type, demand more research on prevention guidelines, diagnostic tools and treatment for UCB.
Subject(s)
Carcinoma, Transitional Cell/epidemiology , Urinary Bladder Neoplasms/epidemiology , Aged , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/history , Carcinoma, Transitional Cell/mortality , Female , History, 20th Century , History, 21st Century , Humans , Incidence , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Norway/epidemiology , Proportional Hazards Models , Registries , Risk Factors , Survival Rate , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/history , Urinary Bladder Neoplasms/mortalityABSTRACT
A study was made of ovaries perfused in vitro with a liquid fluorocarbon that was stabilized in emulsion by a nonionic detergent to which tissue culture medium was added. A pulsatile flow was used in an organ preservation system under aseptic conditions. Glucose was utilized and lactate produced at a fairly constant rate for as long as 20 hours of perfusion. 14-C-progesterone and 14-C-17alphaOH-progesterone were synthesized from 14-C-acetate and estradiol was secreted. The production of these steroids by the perfused ovary appears to be responsive to gonadotropins.
