title: Bladder cancer in Spain 2011: population based study.
abstract: OBJECTIVE
  We estimate the annual incidence of bladder cancer in Spain and describe the clinical profile of patients with bladder cancer enrolled in a population based study.
  
  
  METHODS
  Using the structure of the Spanish National Health System as a basis, in 2011 the AEU (Spanish Association of Urology) conducted this study with a representative sample from 26 public hospitals and a reference population of 10,146,534 inhabitants, comprising 21.5% of the Spanish population.
  
  
  RESULTS
  A total of 4,285 episodes of bladder cancer were diagnosed, of which 2,476 (57.8%) were new cases and 1,809 (42.2%) were cases of recurrence, representing an estimated 11,539 new diagnoses annually in Spain. The incidence of bladder cancer in Spain, age adjusted to the standard European population, was 20.08 cases per 100,000 inhabitants (95% CI 13.9, 26.3). Of patients diagnosed with a first episode of bladder cancer 84.3% were male, generally older than 59 years (81.7%) with a mean ± SD age of 70.5 ± 11.4 years. Of these patients 87.5% presented with some type of clinical symptom, with macroscopic hematuria (90.8%) being the most commonly detected. The majority of primary tumors were nonmuscle invasive (76.7%) but included a high proportion of high grade tumors (43.7%). According to the ISUP (International Society of Urologic Pathology)/WHO (2004) classification 51.1% was papillary high grade carcinoma. Carcinoma in situ was found in 2.2% of primary and 5.8% of recurrent cases.
  
  
  CONCLUSIONS
  The incidence of bladder cancer in Spain, age adjusted to the standard European population, confirms that Spain has one of the highest incidences in Europe. Most primary nonmuscle invasive bladder cancer corresponded to high risk patients but with a low detected incidence of carcinoma in situ.
authors.forename: B
authors.initials: B
authors.lastname: Miñana
authors.forename: J M
authors.initials: JM
authors.lastname: Cózar
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authors.initials: J
authors.lastname: Palou
authors.forename: M
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authors.lastname: Unda Urzaiz
authors.forename: R A
authors.initials: RA
authors.lastname: Medina-Lopez
authors.forename: Jorge
authors.initials: J
authors.lastname: Subirá Ríos
authors.forename: F
authors.initials: F
authors.lastname: de la Rosa-Kehrmann
authors.forename: V
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authors.lastname: Chantada-Abal
authors.forename: F
authors.initials: F
authors.lastname: Lozano
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Ribal
authors.forename: E
authors.initials: E
authors.lastname: Rodríguez Fernández
authors.forename: J
authors.initials: J
authors.lastname: Castiñeiras Fernández
authors.forename: Tomás
authors.initials: T
authors.lastname: Concepción Masip
authors.forename: M J
authors.initials: MJ
authors.lastname: Requena-Tapia
authors.forename: J
authors.initials: J
authors.lastname: Moreno-Sierra
authors.forename: M
authors.initials: M
authors.lastname: Hevia
authors.forename: A
authors.initials: A
authors.lastname: Gómez Rodríguez
authors.forename: C
authors.initials: C
authors.lastname: Martínez-Ballesteros
authors.forename: M
authors.initials: M
authors.lastname: Ramos
authors.forename: José H
authors.initials: JH
authors.lastname: Amón Sesmero
authors.forename: P
authors.initials: P
authors.lastname: Pizá Reus
authors.forename: A
authors.initials: A
authors.lastname: Bohorquez Barrientos
authors.forename: Carlos
authors.initials: C
authors.lastname: Rioja Sanz
authors.forename: J Angel
authors.initials: JA
authors.lastname: Gomez-Pascual
authors.forename: E
authors.initials: E
authors.lastname: Hidalgo Zabala
authors.forename: J L
authors.initials: JL
authors.lastname: Parra Escobar
authors.forename: O
authors.initials: O
authors.lastname: Serrano
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D015897:Comorbidity; D005260:Female; D006417:Hematuria / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011159:Population Surveillance; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin
keywords: BC; BCG; BMI; CIS; MMC; NMIBC; Spain; TURBT; bacillus Calmette-Guérin; bladder cancer; body mass index; carcinoma in situ; incidence; mitomycin C; neoplasm staging; nonmuscle invasive bladder cancer; transurethral bladder tumor resection; urinary bladder neoplasms