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Abstract
Purpose
To understand the potential impact of new treatment options for urinary tract cancer, recent population trends in incidence, mortality and survival should be elucidated. This study estimated changes in the incidence, mortality and relative survival of urinary tract cancer in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) between 1990 and 2019.
Methods
Annual counts of incident cases and deaths due to urinary tract cancer (International Classification of Diseases, Tenth Revision, Clinical Modification codes C65–C68, D09.0–D09.1, D30.1–D30.9 and D41.1–D41.9) in Nordic countries were retrieved in 5-year age categories by sex during the study period. Country-specific time trends (annual rate ratios [RRs]) were estimated using Poisson regression, and RRs were compared between sexes.
Results
The incidence rate of bladder and upper urothelial tract cancer was >3-times lower in women than men in all countries across all age groups (incidence RR for women to men ranging from 0.219 [95% CI = 0.213–0.224] in Finland to 0.291 [95% CI = 0.286–0.296] in Denmark). Incidence rates were lowest in Finland and highest in Norway and Denmark. Age-adjusted mortality decreased in Finland, Denmark and Norway and in Swedish men, with the greatest decrease seen in Danish men (annual RR = 0.976; 95% CI = 0.975–0.978). In all countries and age groups, women had a lower relative survival rate than men.
Conclusion
Between 1990 and 2019, the incidence of urinary tract cancer was stable in the Nordic countries, while mortality rates declined and relative survival increased. This could be due to earlier diagnosis and better treatment.
Acknowledgments
The authors thank Solveig Borkenhagen (employee at Oslo Economics) for performing significant work in data collection and analysis. Editorial support was provided by Clinical Thinking and was funded by Merck (CrossRef Funder ID: 10.13039/100009945) and Pfizer.
Disclosure statement
Eemil Karttunen is an employee at Merck OY, Espoo, Finland, an affiliate of Merck KGaA. Petteri Hervonen was affiliated with Helsinki University Hospital at the time the research was conducted and is now an employee of Janssen-Cilag Oy, Espoo, Finland, an affiliate of Johnson & Johnson, and reports advisory roles at Bristol Myers Squibb, MSD, Pfizer and Roche, and participation in clinical studies funded by MSD. Jan Oldenburg reports receiving grant support from MSD, consulting fees from Astellas, AstraZeneca, Bayer, Eisai, Ipsen and Janssen-Cilag, grant support and consulting fees from Bristol Myers Squibb, Merck and Roche, and participation in speakers bureaus sponsored by Astellas, AstraZeneca, Bayer and Bristol Myers Squibb. Helle Pappot reports receiving grant support from MSD, Pfizer and Roche. Henrik Støvring reports receiving consulting fees from AstraZeneca, Bristol Myers Squibb, Merck and Pfizer. Juan Luiz Vázquez reports advisory board participation for Photocure and a pending patent for the OPFIELD electrode. Suzanne Bergman is an employee at Merck AB, Solna, Sweden, an affiliate of Merck KGaA. Gry Magnussen is an employee at Merck AB NUF, Oslo, Norway, an affiliate of Merck KGaA. Steinar Thoresen is a consultant at Merck AB NUF, Oslo, Norway, an affiliate of Merck KGaA. Pernille Norremark is an employee at Merck A/S, Søborg, Denmark, an affiliate of Merck KGaA. Anders Ullén has received speaker honoraria or served on an advisory board for Astellas, Janssen-Cilag, Merck, MSD, Pierre-Fabre and Roche. Abolfazl Hosseini and Jukka Sairanen report no conflicts of interest.
Data availability statement
A public database was used as the source of data and all data are available at the website (https://nordcan.iarc.fr/en). Please see the Methods section for details.