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Early Stage Bladder Cancer (early_stage + bladder_cancer)

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Medical Sciences100%

Selected Abstracts

Patterns of care for early stage bladder cancer,,

CANCER, Issue 11 2010
Seth A. Strope MD
Abstract BACKGROUND: Early stage bladder cancer is a heterogeneous disease with a variable risk of progression and mortality. Uncertainty surrounding the optimal care for these patients may result in a mismatch between disease risk and treatment intensity. METHODS: Using Surveillance, Epidemiology, End Results-Medicare data, we identified patients diagnosed with early stage bladder cancer (n = 24,980) between 1993 and 2002. We measured patients' treatment intensity by totaling all Medicare payments made for bladder cancer in the 2 years after diagnosis. Using multiple logistic regression, we assessed relationships between clinical characteristics and treatment intensity. Finally, we determined the extent to which a patient's disease risk matched with their treatment intensity. RESULTS: The average per capita expenditures increased from $6,936 to $7,642 over the study period (10.2% increase; P < .01). This increase was driven by greater use of intravesical therapy (2.6 vs 3.7 instillations per capita, P < .01) and physician office visits (3.0 vs 4.8 visits per capita, P < .01). Generally, treatment intensity was appropriately aligned with many clinical characteristics, including age, comorbidity, tumor stage, and grade. However, treatment intensity matched disease risk for only 55% and 49% of the lowest and highest risk patients, respectively. CONCLUSIONS: The initial treatment intensity of early stage bladder cancer is increasing, primarily through greater use of intravesical therapy and office visits. Treatment intensity matches disease risk for many, but up to 1 in 5 patients may receive too much or too little care, suggesting opportunities for improvement. Cancer 2010. © 2010 American Cancer Society. [source]

The Drake Health Registry Study: Findings from fifteen years of continuous bladder cancer screening

AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2003
Gary M. Marsh PhD
Abstract Background The Drake Health Registry Study (DHRS) is an ongoing bladder cancer screening program initiated in 1986 due to workers' probable past exposure to the bladder carcinogen, beta-naphthylamine (BNA). Methods At periodic screening visits, a health survey is administered and three screening tests are applied to a urine sample, urinalysis (UA), papanicolaou (PAP), and quantitative fluorescence image analysis (QFIA). Positive screens are eligible for a free bladder cystoscopy with random biopsies. Results Forty of 51 persons eligible for diagnostic evaluation underwent cystoscopy. One person was diagnosed with carcinoma in situ, two with transitional cell papilloma, 14 with dysplasia, two of which developed transitional cell carcinoma; 26 had bladder abnormalities such as chronic inflammation, chronic cystitis, atypical changes, atypia, hyperplasia, or papillary clusters. Conclusions The DHRS continues to identify early stage bladder cancer and other abnormalities among workers exposed to BNA before 1981 and generates useful clinical, psycho-social, and epidemiologic data. Am. J. Ind. Med. 43: 142,148, 2003. © 2003 Wiley-Liss, Inc. [source]

Patterns of care for early stage bladder cancer,,

CANCER, Issue 11 2010
Seth A. Strope MD
Abstract BACKGROUND: Early stage bladder cancer is a heterogeneous disease with a variable risk of progression and mortality. Uncertainty surrounding the optimal care for these patients may result in a mismatch between disease risk and treatment intensity. METHODS: Using Surveillance, Epidemiology, End Results-Medicare data, we identified patients diagnosed with early stage bladder cancer (n = 24,980) between 1993 and 2002. We measured patients' treatment intensity by totaling all Medicare payments made for bladder cancer in the 2 years after diagnosis. Using multiple logistic regression, we assessed relationships between clinical characteristics and treatment intensity. Finally, we determined the extent to which a patient's disease risk matched with their treatment intensity. RESULTS: The average per capita expenditures increased from $6,936 to $7,642 over the study period (10.2% increase; P < .01). This increase was driven by greater use of intravesical therapy (2.6 vs 3.7 instillations per capita, P < .01) and physician office visits (3.0 vs 4.8 visits per capita, P < .01). Generally, treatment intensity was appropriately aligned with many clinical characteristics, including age, comorbidity, tumor stage, and grade. However, treatment intensity matched disease risk for only 55% and 49% of the lowest and highest risk patients, respectively. CONCLUSIONS: The initial treatment intensity of early stage bladder cancer is increasing, primarily through greater use of intravesical therapy and office visits. Treatment intensity matches disease risk for many, but up to 1 in 5 patients may receive too much or too little care, suggesting opportunities for improvement. Cancer 2010. © 2010 American Cancer Society. [source]