Closing the Gender Gap: Can We Improve Bladder Cancer Survival in Women? - A Systematic Review of Diagnosis, Treatment and Outcomes

Abstract

Introduction: Despite recent attention, there are no gender specific guidelines to address the disparity in bladder cancer survival between the sexes. The focus of this review was to identify areas of clinical practice that may influence bladder cancer outcomes and to provide evidence-based recommendations to improve bladder cancer survival in women. Method: A systematic search of MEDLINE was conducted to identify studies related to referral, diagnosis, treatment and outcomes of patients with bladder cancer with particular reference to gender differences. Results: Patients' knowledge of key signs and symptoms of bladder cancer is poor. There is evidence that there is a gender difference in referral patterns both at patient and primary care level. The presence of cystits, in particular, delays referral. Treatment and surveillance of high-risk non-muscle invasive cancers is variable and non-urothelial bladder cancer, which has higher incidence in women is more likely to be treated non-operatively than urothelial bladder cancer. Conclusion: We have offered recommendations to improve patient education and streamline referrals and suggested considerations for treatment of high-risk cancers to help improve survival in female bladder cancer patients.

High Androgen Receptor mRNA Expression Is Independently Associated with Prolonged Cancer-Specific and Recurrence-Free Survival in Stage T1 Bladder Cancer

“…Although previous results in mouse models suggest that functional AR signaling is involved in the initiation of UCB [7], our data implicate a better outcome upon elevated AR expression in NMIBC. However, available data from other studies suggest an improved course of disease for patients with UCB who received antiandrogen therapy for prostate cancer [12].…”

“…The fact that the incidence of UCB is increased by three-fold in men compared with women, even when adjusted for environmental and lifestyle factors [5], and that women have a worse outcome [6], [7] has led to the hypothesis of UCB being an endocrine-related malignancy. Particularly, the role of the androgen receptor (AR) in the tumorigenesis and progression of UCB has been the focus of several studies [8], [9], [10], [11].…”

Sodium butyrate inhibits migration and induces AMPK‐mTOR pathway‐dependent autophagy and ROS‐mediated apoptosis via the miR‐139‐5p/Bmi‐1 axis in human bladder cancer cells

“…There are approximately 430,000 new patients every year. [1][2][3][4] Approximately 75% of cases are NMIBC, and 25% are MIBC. Generally, NMIBC is treated with timely endoscopic resection and intravesical therapy, whereas MIBC is managed with cystectomy with or without chemotherapy.…”

“…Among all bladder cancer cases, approximately 75% occur in men, which represents a strong male predominance. [1][2][3][4] Three-quarters of cases are NMIBC (non-muscle invasive bladder cancer), and the rest are MIBC (muscle invasive bladder cancer) or metastatic disease. NMIBC is classified into three groups: low risk, intermediate risk, and high risk according to different conditions.…”

Psychosocial Distress in Bladder Cancer Stratified by Gender, Age, Treatment, and Tumour Stage

“…There are only few data on gender-specific psycho-oncological differences in BC patients although outcomes and morbidity in BC are different in men and women [23]. Gacci et al [24] evaluated differences in HRQOL among female BC patients undergoing various surgical procedures for definitive urinary diversion after radical cystectomy.…”