Incidence, mortality and survival of bladder neoplasms in the Czech Republic in the period 1977–2017

This study aimed to perform a complex time trend analysis of incidence, mortality, and
survival of 76,505 patients with bladder neoplasms based on the Czech National Cancer Registry
for 1977–2017. Materials and methods: The time trends of incidence and mortality were evaluated
using the joinpoint regression. The relative survival and Cox proportional hazards model
were used for survival analysis. Results: After 2004, a signifi cant annual decrease by 1.9% in the
incidence of malignant tumors of the bladder (C67) was observed, accompanied by a sharp
annual increase in the incidence of in situ bladder cancer (D090) by 16.9%. For mortality from
malignant tumors of the bladder, a signifi cant decrease by 1.4% annually was detected after
1998. The decline in both incidence and mortality was most pronounced in the below-65 years
age group and in patients with a localized stage at dia gnosis. While a signifi cant decline in both
incidence and mortality was observed for the fi rst primary malignant tumors of the bladder,
both these measures increased for malignant tumors of the bladder as subsequent primary
neoplasms. The fi ve-year relative survival of patients with malignant tumors of the bladder
increased from 52.1% in 1990–1993 to 62.3% in 2013–2017. However, comparing the periods
2003–2007 and 2013–2017, a decrease has been observed. Conclusion: The decrease in the
incidence and survival of malignant tumors of the bladder in the recent period is in particular
caused by improved detection of in situ bladder cancer and classifi cation changes. Other reasons
for the decreasing survival include the increasing age at dia gnosis, the growing number
of subsequent primary neoplasms, and the increasing proportion of smokers among patients.