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Kraywinkel, Klaus; Fiebig, Julia and Schulz, Gerald Bastian (2018): Epidemiologie des Harnblasenkarzinoms in Deutschland. In: Onkologe, Vol. 24, No. 1: pp. 6-13

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This article presents an overview of the incidence, mortality and survival rates of urinary bladder cancer in Germany, based on the German population-based cancer registry data and official statistics on causes of death. Due to the clinical relevance, morphologically non-invasive tumors, which comprise nearly half of the 30,000 new cases per year in Germany, are included in the analyses although according to the ICD-10 classification, neither non-invasive papillary tumors (Ta) nor the rare flat in situ tumors of the urinary bladder (Tis) are classified as malign neoplasms. Clinically, these tumors are subsumed as non-muscle-invasive tumors together with T1 tumors, which invade subepithelial connective tissue but not the muscle of the bladder. Histologically at least 94% of malignant tumors of the bladder are urothelial carcinomas while other forms, such as squamous cell or adenocarcinoma are rare. The median age at diagnosis is just below 75 years. Men are affected approximately three times more often than women. In 2015 approximately 5700 people in Germany died from urinary bladder cancer but age standardized mortality rates are considerably declining in Germany and are among the lowest in the European Union. International comparisons of incidence and survival are hampered by different practices regarding non-invasive tumors in the cancer registries, but survival rates in Germany are largely comparable to those calculated from US-SEER registries. The relative survival for muscle-invasive tumors 10 years after diagnosis is below 40%, while for non-muscle-invasive tumors it varies between 63% and 94% according to tumor stage and grading. Especially for non-muscle-invasive high-grade tumors, the survival rate is largely influenced by the risk of progression to muscle-invasive carcinoma, which is likely to be elevated over many years even after intensive treatment.

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