Urinary Risk Factors for Bladder Cancer

Posted by e-Medical PPT Saturday, August 11, 2012
Bladder Cancer Incidence
Most common type of urinary tract cancer
More than 61,000 new cases of bladder cancer and approximately 13,000 deaths in 2005.
Approximately 70% of new cases occur in men and 30% in women

Types of Bladder Cancer
Transitional cell carcinoma is the most common, followed by squamous cell carcinoma
Cancer is staged by the layers of the bladder invaded and by cancer spread
As cancer penetrates the layers, it has a higher chance to spread and becomes harder to treat

Causes of Bladder Cancer
Bladder cancer is believed to develop primarily as a result of environmental factors
Chronic damage to the cells lining the bladder ultimately leads to DNA changes (Somatic Mutation)
True inherited mutations are rare (Germline Mutation), although genetics raise other issues

Cardinal Symptom: Hematuria
Most common presenting symptom or sign for bladder cancer is hematuria
Hematuria is a common symptom and sign with many causes that can range in clinical importance:
insignificant, eg. urethral polyps
significant requiring observation, eg. cystocele
significant requiring treatment, eg. pyelonephritis 
life-threatening, eg. bladder cancer

Gross hematuria is always cause for concern and requires intensive work-up
 30% of patients with gross hematuria are diagnosed with bladder cancer
Microscopic hematuria may also require intensive work-up depending on degree
 greater numbers of bladder cancer patients present with microscopic hematuria
Patients at high risk for bladder cancer have additional risk factors

Risk Factor : Urinary Disorders
Chronic inflammation of the bladder increases the risk of bladder cancer
Irritative effect leads to cell damage over time
Common history includes: 
  repeated urinary tract infection, eg. cystitis
  recurrent kidney, ureter or bladder calculi
  chronic urinary retention requiring catheter (spinal cord injury or neurogenic bladder)..
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