Invasive Bladder Cancer: Support for Screening

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Abstract
Of 297 patients with bladder cancer treated during 1975-1981, 90 (30%) had histologic documentation of muscle invasion, 82 of whom (91%) had invasion into the muscle at the time of presentation. Of these 82 patients 51 (62%) had tumor localized to the bladder after clinical staging. Of 36 patients undergoing radical cystectomy 9 (25%) had microscopic pelvic lymph node involvement. Nine patients underwent urinary diversion alone and 31 presented with perivesical or pelvic nodal tumor extension, or distant metastases. Only 8 of the 90 patients (9%) had prior superficial bladder cancer. The mean survival for patients with stage B to C disease at diagnosis was 23 mo. and for those with stage D tumor it was 11 mo. This experience indicates that the majority of patients with advanced bladder cancer are not identified at a stage when definitive therapy offers an excellent prognosis. More resources must be devoted to earlier detection.