{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:54:13Z","timestamp":1789001653006,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the causes of the decrease in bladder cancer survival that has occurred over the past four decades.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted data from the South Australian Cancer Registry. Data from the period 1 January 1977 to 31 December 2020 were extracted to explore changes in incidence and survival among a total of 8356 patients diagnosed with \u2265pT1 disease. Invasive bladder cancer was defined as \u2265pT1 in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Invasive bladder cancer age\u2010standardized incidence decreased from 7.20 cases per 100\u2009000 people in 1977 to 5.85 cases per 100\u2009000 in 2020. The mean age at diagnosis increased from 68\u2009years to 76\u2009years. The crude incidence for patients aged 80\u2009years and over increased by 3.3% per year (95% confidence interval [CI] 2.1 to 4.6). Overall survival decreased over the study period (hazard ratio [HR] 1.22 [95% CI 1.09 to 1.35]), however, survival increased after adjusting for age at diagnosis (HR 0.80 [95% CI 0.76 to 0.94]). Despite a decrease in non\u2010bladder cancer\u2010specific deaths in older people, there was no change in the bladder cancer\u2010specific death rate in older people (HR 0.94 [95% CI 0.70 to 1.26]). Male sex was associated with higher survival (HR 0.87 [95% CI 0.83 to 0.92]), whereas socioeconomic advantage was not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Invasive bladder cancer survival has decreased over the past 40\u2009years, with the age structure of the population being a significant contributing factor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient summary<\/jats:title>\n                    <jats:p>We looked at why bladder cancer survival is decreasing using a large cancer registry with information from 1977 to 2020. We found that people are now more likely to be diagnosed at an older age. Older people often live for a shorter time with bladder cancer compared to younger people. Bladder cancer survival has decreased because there are more older people with the disease than previously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16286","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T01:40:00Z","timestamp":1708998000000},"page":"699-708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Lessons from a population\u2010based bladder cancer registry: exploring why survival is not improving"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7404-2356","authenticated-orcid":false,"given":"Jake A.","family":"Tempo","sequence":"first","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide SA Australia"},{"name":"Urology Unit Austin Health  Melbourne VIC 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