title: Swedish National Registry of Urinary Bladder Cancer: No difference in relative survival over time despite more aggressive treatment.
abstract: OBJECTIVE
  The aim of this study was to use the Swedish National Registry of Urinary Bladder Cancer (SNRUBC) to investigate changes in patient and tumour characteristics, management and survival in bladder cancer cases over a period of 15 years.
  
  
  METHODS
  All patients with newly detected bladder cancer reported to the SNRUBC during 1997-2011 were included in the study. The cohort was divided into three groups, each representing 5 years of the 15 year study period.
  
  
  RESULTS
  The study included 31,266 patients (74% men, 26% women) with a mean age of 72 years. Mean age was 71.7 years in the first subperiod (1997-2001) and 72.5 years in the last subperiod (2007-2011). Clinical T categorization changed from the first to the last subperiod: Ta from 45% to 48%, T1 from 21.6% to 22.4%, and T2-T4 from 27% to 25%. Also from the first to the last subperiod, intravesical treatment after transurethral resection for T1G2 and T1G3 tumours increased from 15% to 40% and from 30% to 50%, respectively, and cystectomy for T2-T4 tumours increased from 30% to 40%. No differences between the analysed subperiods were found regarding relative survival in patients with T1 or T2-T4 tumours, or in the whole cohort.
  
  
  CONCLUSIONS
  This investigation based on a national bladder cancer registry showed that the age of the patients at diagnosis increased, and the proportion of muscle-invasive tumours decreased. The treatment of all tumour stages became more aggressive but relative survival showed no statistically significant change over time.
authors.affiliation: a 1 Department of Urology, IBK, Linköping University , Linköping, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Jahnson
authors.affiliation: b 2 Department of Urology, Karolinska University Hospital , Stockholm, Sweden.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Hosseini Aliabad
authors.affiliation: c 3 Department of Urology, Sahlgrenska University Hospital , Gothenburg, Sweden.
authors.forename: Sten
authors.initials: S
authors.lastname: Holmäng
authors.affiliation: a 1 Department of Urology, IBK, Linköping University , Linköping, Sweden.
authors.forename: Georg
authors.initials: G
authors.lastname: Jancke
authors.affiliation: d 4 Department of Urology, Skåne University Hospital , Malmö, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Liedberg
authors.affiliation: e 5 Department of Urology, Northern University Hospital , Umeå, Sweden.
authors.forename: Börje
authors.initials: B
authors.lastname: Ljungberg
authors.affiliation: f 6 Department of Urology, Uppsala University Hospital , Uppsala, Sweden.
authors.forename: Per-Uno
authors.initials: PU
authors.lastname: Malmström
authors.affiliation: g 7 Department of Urology, Regional Cancer Center South East , Linköping, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Rosell
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D015996:Survival Rate; D013548:Sweden; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine
keywords: Bladder cancer; population-based; survival