Epidemiology, Incidence and Mortality of Bladder Cancer and their Relationship with the Development Index in the World

  • Mahdavifar, Neda (Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences) ;
  • Ghoncheh, Mahshid (Department of Epidemiology and Biostatistics, Hamadan University of medical sciences) ;
  • Pakzad, Reza (Department of Epidemiology and Biostatistics, school of public health, Tehran University of medical sciences) ;
  • Momenimovahed, Zohre (Qom University of Medical Sciences) ;
  • Salehiniya, Hamid (Department of Epidemiology and Biostatistics, school of public health, Tehran University of medical sciences)
  • Published : 2016.02.05


Background: Bladder cancer is an international public health problem. It is the ninth most common cancer and the fourteenth leading cause of death due to cancer worldwide. Given aging populations, the incidence of this cancer is rising. Information on the incidence and mortality of the disease, and their relationship with level of economic development is essential for better planning. The aim of the study was to investigate bladder cancer incidence and mortality rates, and their relationship with the the Human Development Index (HDI) in the world. Materials and Methods: Data were obtained from incidence and mortality rates presented by GLOBOCAN in 2012. Data on HDI and its components were extracted from the global bank site. The number and standardized incidence and mortality rates were reported by regions and the distribution of the disease were drawn in the world. For data analysis, the relationship between incidence and death rates, and HDI and its components was measured using correlation coefficients and SPSS software. The level of significance was set at 0.05. Results: In 2012, 429,793 bladder cancer cases and 165,084 bladder death cases occurred in the world. Five countries that had the highest age-standardized incidence were Belgium 17.5 per 100,000, Lebanon 16.6/100,000, Malta 15.8/100,000, Turkey 15.2/100,000, and Denmark 14.4/100,000. Five countries that had the highest age-standardized death rates were Turkey 6.6 per 100,000, Egypt 6.5/100,000, Iraq 6.3/100,000, Lebanon 6.3/100,000, and Mali 5.2/100,000. There was a positive linear relationship between the standardized incidence rate and HDI (r=0.653, P<0.001), so that there was a positive correlation between the standardized incidence rate with life expectancy at birth, average years of schooling, and the level of income per person of population. A positive linear relationship was also noted between the standardized mortality rate and HDI (r=0.308, P<0.001). There was a positive correlation between the standardized mortality rate with life expectancy at birth, average years of schooling, and the level of income per person of population. Conclusions: The incidence of bladder cancer in developed countries and parts of Africa was higher, while the highest mortality rate was observed in the countries of North Africa and the Middle East. The program for better treatment in developing countries to reduce mortality from the cancer and more detaiuled studies on the etiology of are essential.


Incidence;mortality;bladder cancer;development index;world


  1. Bray F, Jemal A, Grey N, et al (2012). Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. The Lancet Oncol, 13, 790-801.
  2. Brookfield KF, Cheung MC, Gomez C, et al (2009). Survival disparities among African American women with invasive bladder cancer in Florida. Cancer, 115, 4196-209.
  3. Burger M, Catto JW, Dalbagni G, et al (2013). Epidemiology and risk factors of urothelial bladder cancer. European urology, 63, 234-41.
  4. Chavan S, Bray F, Lortet-Tieulent J, et al (2014). International variations in bladder cancer incidence and mortality. European Urology, 66, 59-73.
  5. Cirla PE, Martinotti I, Foa V (2011). [Occupational exposure to chemical carcinogens between estimates and reality: an Italian multicentric study in Lombardy]. G Ital Med Lav Ergon, 33, 85-7.
  6. Coleman MP, Babb P, Sloggett A, et al (2001). Socioeconomic inequalities in cancer survival in England and Wales. Cancer, 91, 208-16.<208::AID-CNCR6>3.0.CO;2-E
  7. Colombel M, Soloway M, Akaza H, et al (2008). Epidemiology, staging, grading, and risk stratification of bladder cancer. European Urology Ssupplements, 7, 618-26.
  8. Ferlay J, Randi G, Bosetti C, et al (2008). Declining mortality from bladder cancer in Europe. BJU international, 101, 11-9.
  9. Ferlay J, Soerjomataram I, Dikshit R, et al (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International Journal of Cancer, 136, 359-86.
  10. Gandini S, Botteri E, Iodice S, et al (2008). Tobacco smoking and cancer: a meta-analysis. Int J Cancer, 122, 155-64.
  11. Ghoncheh M, Mohammadian-Hafshejani A, Salehiniya H (2015). Incidence and Mortality of Breast Cancer and their Relationship to Development in Asia. Asian Pac J Cancer Prev, 16, 6081-7.
  12. Gilmore J (2002). Report on smoking prevalence in Canada. Statistics Canada, Ottawa.
  13. Giovino GA, Mirza SA, Samet JM, et al (2012). Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. The Lancet, 380, 668-79.
  14. Griggs JJ, Culakova E, Sorbero ME, et al (2007). Effect of patient socioeconomic status and body mass index on the quality of breast cancer adjuvant chemotherapy. J Clin Oncol, 25, 277-84.
  15. Hussain SK, Lenner P, Sundquist J, et al (2008). Influence of education level on cancer survival in Sweden. Ann Oncol, 19, 156-62.
  16. Agudo A, Bonet C, Travier N, et al (2012). Impact of cigarette smoking on cancer risk in the European prospective investigation into cancer and nutrition study. J Clin Oncol, 30, 4550-7.
  17. Brausi M, Witjes JA, Lamm D, et al (2011). A review of current guidelines and best practice recommendations for the management of nonmuscle invasive bladder cancer by the International Bladder Cancer Group. J Urol, 186, 2158-67.
  18. Jemal A, Thun MJ, Ries LA, et al (2008). Annual report to the nation on the status of cancer, 1975-2005, featuring trends in lung cancer, tobacco use, and tobacco control. J National Cancer Institute, 100, 1672-94.
  19. Kaufman DS, Shipley WU, Feldman AS (2009). Bladder cancer. Lancet, 374, 239-49.
  20. Keyghobadi N, Rafiemanesh H, Mohammadian-Hafshejani A, et al (2015). Epidemiology and trend of cancers in the province of Kerman: southeast of Iran. Asian Pac J Cancer Prev, 16, 1409-13.
  21. Klotz L, Brausi MA (2015). World urologic oncology federation bladder cancer prevention program: a global initiative. urologic oncology: seminars and original investigations. Elsevier, 25-9.
  22. Kogevinas M PN, Susser M, et al (1997). Social Inequalities and Cancer. Lyon, France. IARC Scientific Publications.
  23. Lehto US, Ojanen M, Dyba T, et al (2006). Baseline psychosocial predictors of survival in localised breast cancer. Br J Cancer, 94, 1245-52.
  24. Malats N, Real FX (2015). Epidemiology of Bladder Cancer. Hematology/oncology clinics of North America, 29, 177-89.
  25. Malik K (2013). Human development report 2013. The rise of the South: Human progress in a diverse world. The Rise of the South: Human Progress in a Diverse World (March 15, 2013). UNDP-HDRO Human Development Reports.
  26. Parkin DM (2006). The global health burden of infection associated cancers in the year 2002. Intern J Cancer, 118, 3030-44.
  27. Pelucchi C, Bosetti C, Negri E, et al (2006). Mechanisms of disease: The epidemiology of bladder cancer. Nat Clin Pract Urol, 3, 327-40.
  28. Ploeg M, Aben KK, Kiemeney LA (2009). The present and future burden of urinary bladder cancer in the world. World J Urol, 27, 289-93.
  29. Razi S, Rafiemanesh H, Ghoncheh M, et al (2015). Changing Trends of Types of Skin Cancer in Iran. Asian Pac J Cancer Prev, 16, 4955-8.
  30. Salem HK, Mahfouz S (2012). Changing patterns (age, incidence, and pathologic types) of schistosoma-associated bladder cancer in Egypt in the past decade. Urology, 79, 379-83.
  31. Shackley DC, Clarke NW (2005). Impact of socioeconomic status on bladder cancer outcome. Current Opinion in Urol, 15, 328-31.
  32. Siddiqui MM, Heney NM, McDougal WS, et al (2015). Disparities in overall and urothelial carcinoma specific mortality associated with healthcare insurance status. Bladder, 2, 10.
  33. Sievert KD, Amend B, Nagele U, et al (2009). Economic aspects of bladder cancer: what are the benefits and costs? World J Urol, 27, 295-300.
  34. Silverman D, Devesa S, Moore L, et al (2006). Cancer epidemiology and prevention. Bladder Cancer, 2, 1156-79.
  35. Spiegel D (2002). Effects of psychotherapy on cancer survival. Nat Rev Cancer, 2, 383-9.
  36. Spiegel D, Bloom JR, Kraemer HC, et al (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888-91.
  37. Spiegel D, Giese-Davis J (2003). Depression and cancer: mechanisms and disease progression. Biol Psychiatry, 54, 269-82.
  38. Trinh QD, Schmitges J, Sun M, et al (2012). Morbidity and mortality of radical prostatectomy differs by insurance status. Cancer, 118, 1803-10.
  39. van Vliet EP, Eijkemans MJ, Steyerberg EW, et al (2006). The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands. Br J Cancer, 95, 1180-5.
  40. Wagner K-H, Brath H (2012). A global view on the development of non communicable diseases. Preventive medicine, 54, 38-41.
  41. Yang Y, Wang JJ, Wang CX, et al (2010). Awareness of tobaccorelated health hazards among adults in China. Biomed Environ Sci, 23, 437-44.
  42. Yuge K, Kikuchi E, Matsumoto K, et al (2011). Could patient age influence tumor recurrence rate in non-muscle-invasive bladder cancer patients treated with BCG immunotherapy? Jpn J Clin Oncol, 41, 565-70.

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