Female bladder cancer: incidence, treatment, and outcome

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Abstract
Women are generally less likely to develop bladder cancer compared with men; however, once they acquire this disease, they have a less favorable prognosis. In this review, we describe our current understanding of the relationship between sex and bladder cancer incidence and outcomes and discuss the most recent developments in this area of research. Despite some evidence suggesting involvement of hormonal factors in bladder cancer carcinogenesis, the exact mechanisms responsible for increased bladder cancer incidence in men are still incompletely understood. The causes of increased mortality in women are also unclear. It has been hypothesized that women present with more advanced stages (and thus have inferior survival) than men because early signs of bladder cancer in women are often attributed to more common benign conditions. However, recent studies have shown that excess mortality in women persists after adjustment for stage and other tumor characteristics. Women also do not appear to be significantly undertreated for bladder cancer. Despite considerable research efforts, both increased incidence in men and decreased survival in women remain somewhat of a mystery. The causes of these phenomena may include poorly understood biological factors or environmental influences, which may become a subject of future research.