Prospective registration of all patients in a geographical region with newly diagnosed bladder carcinomas during a two-year period

Objective. To report the age, stage and grade of all patients with newly di agnosed bladder carcinoma in a well-defined geographical region and to comp are this cohort with previous reports which come mainly from large referral centres. Material ann methods: All newly diagnosed bladder carcinoma patie nts (n = 701) in Western Sweden were prospectively registered during a 2-ye ar period (1987-88). The histopathological material was re-examined by a re ference pathologist. All the original clinical records were reviewed by one urologist 5-7 years after diagnosis. Demographic data, tumor grade, stage, multiplicity, presence of carcinoma in situ and lymphatic invasion are pre sented. Results: The mean age at diagnosis was 70.5 years. Grade and stage increase with age. The proportion of non-invasive tumors (55%) is higher th an in any previous Scandinavian report. The age-standardized incidence in b ladder carcinoma among men in the largest city (Goteborg) is 55% higher tha n in the rest of the region (p < 0.0001). Deviations between the primary pa thologist and the reviewer with regard to tumor grade were particularly see n in rumors of grades I and II. Conclusions: Differences in mean age, stage and grade distribution were found between the present report, which includ ed all patients with newly diagnosed bladder carcinoma in a geographical ar ea, and other reports, which mainly comprised patients from large treatment centres. These differences can probably and mainly be explained by selecti on factors such as various degrees of inclusion of low-grade papillary tumo rs.