Research Article
The Incidence Rate of Invasive and in Situurinary Bladder Cancer in the United States of America: An Observational Descriptive Epidemiological Analysis of Data from the Centers for Disease Control and Prevention 1999-2014
Ibrahim G Alghamdi*
Department of Bladder Cancer, University of Al-Baha, Saudi Arabia
*Corresponding author: Ibrahim Alghamdi, Department of Bladder Cancer, University of Al-Baha, Saudi Arabia
Published: 05 Oct, 2017
Cite this article as: Alghamdi IG. The Incidence Rate of
Invasive and in Situurinary Bladder
Cancer in the United States of
America: An Observational Descriptive
Epidemiological Analysis of Data from
the Centers for Disease Control and
Prevention 1999-2014. Clin Oncol.
2017; 2: 1351.
Abstract
Background: This study provides descriptive epidemiological data ofinvasiveand in situ urinary
bladder cancer diagnosed from 1999 to 2014 in the United States of America.
Methods: This is a retrospective descriptive epidemiological analysis of invasiveand in situ urinary
bladder cancer recorded in the Centres for Disease Control and Prevention from 1999 to 2014. The
statistical analyses were performed using descriptive statistics to calculate the overall age-adjusted
incidence rate stratified by state, race, and gender.
Results: The state of Rhode Island, Detroit, Delaware, and Seattle had the highest overall age-adjusted
incidence rate of invasive and in situ urinary bladder cancer among male White American, from
1999 to 2014. While, the state of District of Columbia, and New Mexico had the lowest overall ageadjusted
incidence rate of invasive and in situ urinary bladder cancer among male White American,
from 1999 to 2014. The state of Connecticut had the highest overall age-adjusted incidence rate of
invasive and in situ urinary bladder cancer among males Hispanic American, from 1999 to 2014.
Conclusion: This study revealed that the state of Rhode Island, Detroit, Delaware, and Seattle are
the best geographic areas in the United States of America, for studying the most important risk
factors of invasive and in situ urinary bladder cancer among male White American. While, the
state of District of Columbia, and New Mexico are the best geographic areas in the United States of
America, for studying the most important protective factors of invasive and in situ urinary bladder
cancer among White American men. However, the secret for confirming the real risk factor of
invasive and in situ urinary bladder cancer can be found among male Hispanic American living in
the state of Connecticut. Therefore, multiple case-control studies adjusted by race and age should be
conducted in the mentioned states to identify the major risk factors that can be controlled.
Keywords: Cancerepidemiology; Invasiveand in situ urinary bladder cancer; The united states of
America; Age adjusted Incidence rate
Introduction
Bladder cancer is a major health problem in the United States of America (USA) and Europe. It
is estimated that 77,000 new cases and 16,000 deaths per year in the United States of America [1].
The probability of getting bladder cancer is increasing with age in both genders after age 50 [2]. The
incidence rate is higher among White American men than Black and Hispanic American [3].
In the United States of America, the International Agency for Research on Cancer estimated
that the age-adjusted incidence rate for bladder cancer was 11.6 per 100,000 population in 2012, and
the age-adjusted mortality rate was 2.4 per 100,000 population [4-5]. The purpose of this study is
to describe the pattern of invasive and in situ bladder cancer in the United States of America from
1999 to 2014, while focusing on the age adjusted incidence rate, stratified by state, race, and gender.
Materials and Methods
This is a retrospective descriptive epidemiological study of invasive and in situ urinary bladder cancer diagnosed between 1999 and 2014 in the United States of America. The data were available and easily accessible from the website of the Centres for Disease Control and Prevention, through the Official Federal Statistics on cancer incidence registries. Based on these data, there are comprehensive cancer data for the 50 States inthe United States of America, from 1999 to 2014, exploring the ageadjusted incidence rate stratified by state, race, and gender. For data analysis, the Statistical Package for the Social Sciences version 20.0 (SPSS) was used to calculate the mean age-adjusted incidence rate of invasive and in situ urinary bladder cancer from 1999 to 2014.
Table 1
Table 1
Overall age-adjusted incidence rate of invasive and in situurinary bladdercancer in the north east of the United States from 1999 to 2014.
Table 2
Table 2
Overall age-adjusted incidence rate of invasive and in situurinary bladdercancer in the Midwest of the United States from 1999 to 2014.
Results
Urinary Bladder Cancer in the North East of the United
States of America
The overall age-adjusted incidence rate of invasive and in situ
urinary bladder cancer from 1999 to 2014 per 100,000 persons was
calculated from the Centres for Disease Control and Prevention. The
highest overall age-adjusted incidence rate of invasive and in situ
urinary bladder cancer was documented in the state ofRhode Island
with an estimated average for male (51.9 per 100,000 persons). The
estimated overall age-adjusted incidence rates in the state of Rhode
Islandfrom 1999 to 2014were higher among male White American,
compared to other White American men living in the northeast of
the United States. However, the overall age-adjusted incidence rates
of invasive and in situ urinary bladder cancer were higher in White
American men than in Black and Hispanic American men living in
the northeast of America. In addition, the rates of the disease were
approximately very similar among women across all races living in
the northeast of America (Table 1).
The state of Connecticut had the highest overall age-adjusted
incidence rate (40.2 per 100,000 persons) of invasive and in situ
urinary bladder cancer among Hispanic American men, compared to
the samerace and Black American men living in all states of America.
Urinary Bladder Cancer in the Midwest of the United
States of America
Thehighest overall age-adjusted incidence rate of invasive and
in situ urinary bladder cancer was observed in the state ofDetroit
with an estimated average for male (49.0 per 100,000 persons).
The estimated overall age-adjusted incidence rates in the state of
Detroit from 1999 to 2014were higher among White American men,
compared to all races living in the Midwest of the United States.
However, the overall age-adjusted incidence rates of invasive and
in situ urinary bladder cancer were higher in White American men
than in Black and Hispanic American men living in the Midwest of
America. In addition, the rates of the disease were approximately
very similar among women across all races living in the Midwest of
America (Table 2).
Urinary Bladder Cancer in the South of the United States
of America
The highest overall age-adjusted incidence rate of invasive and
in situ urinary bladder cancer was recorded in the state of Delaware
with an estimated average for male (45.7 per 100,000 persons).
The estimated overall age-adjusted incidence rates in the state of
Delaware from 1999 to 2014were higher among White American
men, compared to all races living in the south of the United States.
However, the overall age-adjusted incidence rates of invasive and in
situ urinary bladder cancer were higher in White American men than
in Black and Hispanic American men living in the south of America.
In addition, the rates of the disease were approximately very similar
among women across all races living in the south of America.
The lowest overall age-adjusted incidence rate of invasive and
in situ urinary bladder cancer was observed in the state of District
of Columbia with an estimated average for male (29.0 per 100,000
persons).The estimated overall age-adjusted incidence rates in the
state of District of Columbia from 1999 to 2014were lower among
White American men, compared to the same race living in all states
of America (Table 3).
Urinary Bladder Cancer in the West of the United States
of America
The highest overall age-adjusted incidence rate of invasive and
in situ urinary bladder cancer was documented in the state of Seattle
with an estimated average for male (43.7 per 100,000 persons).
The estimated overall age-adjusted incidence rates in the state of
Seattle from 1999 to 2014 were higher among White American
men, compared to all races living in the west of the United States.
However, the overall age-adjusted incidence rates of invasive and in
situ urinary bladder cancer were higher in White American men than
in Black and Hispanic American men living in the west of America.
In addition, the rates of the disease were approximately very similar
among women across all races living in the west of America.
The lowest overall age-adjusted incidence rate of invasive and in
situ urinary bladder cancer was observed in the state of New Mexico
with an estimated average for male (29.0 per 100,000 persons).The
estimated overall age-adjusted incidence rates in the state of New
Mexico from 1999 to 2014were lower among White American men,
compared to the same race living in all states of America (Table 4).
Table 3
Table 3
Overall age-adjusted incidence rate of invasive and in situurinary bladdercancer in the south of the United States from 1999 to 2014.
Table 4
Table 4
Overall age-adjusted incidence rate of invasive and in situurinary bladder cancer in the west of the United States from 1999 to 2014.
Discussion
This is a descriptive epidemiological study of invasive and in situ
urinary bladder cancer among males and females across all races
in the United States of America, explores a valuable information
about the pattern of the disease in the entire population. It focuses
on the age-adjusted incidence rate of the invasive and in situ urinary
bladdercancer stratified by state, race, and gender. The result of the
study is based on the data recorded in the Centres for Disease Control
and Prevention, from 1999 to 2014.
In the North East of the United States, we have observed that
the highest overall age-adjusted incidence rates of invasive and
in situ urinary bladder cancer among White American men were
documented in the state of Rhode Island from 1999 to 2014.The most
likely reason for this rising age-adjusted incidence rate is that most
White American men living in the state of Rhode Island were more
likely exposed to a specific risk factor that may does not appear in the
same race living in the state of District of Columbia and New Mexico,
that were least affected by invasive and in situurinary bladder cancer.
In addition, the association between bladder cancer and cigarette
smoking has been examined and confirmed in more epidemiological
studies. The majority of these studies showed that the cigarette
smoking is the most important cause of bladder cancer, therefore,
the state of Rhode Island should have had the highest smoking
rate among adults in the United States of America. However, adult
smoking rates in all states of America were recorded by the National
rate CDC, “Current Cigarette Smoking Among Adults-United States,
2005-2015, Smoking Rank (1=Low)”. The smoking rate in the state
of Rhode Island was 15.5% (Rank =14th). While, there were other
states in America that had the highest smoking rates, such as the
state of Kentucky and West Virginia (25.9% and 25.7%) with rank
(51st and 50th), but these states were not high affected by bladder
cancer compared to the mentioned states in the results of this study.
Therefore, multiple case-control studies should be conducted to
identify the most important risk and protective factors for invasive
and in situ bladder cancer among White American men living in
the state of Rhode Island, comparing to the same race living in the
state of District of Columbia and New Mexico that were least affected
by invasive and in situ urinary bladder cancer. Figure 1, shows how
one can identify the most important risk and protective factors for
invasive and in situ bladder cancer among White American men
living in the state of Rhode Island.
The state of Connecticut was the highest area affected in the
northeast of the United States by invasive and in situ bladder cancer
among Hispanic American men, from 1999 to 2014. The most
likely reason for this rising age-adjusted incidence rate is that most
Hispanic American men living in the state of Connecticut were likely
more exposed to a specific risk factor that may does not appear in the
same race and in Black American men living in all states of America.
If we assume that smoking is the major risk factor for bladder cancer
among Hispanic American men in the state of Connecticut, then the
smoking rate should be very high among Hispanic American men,
but the smoking rate was low in the state of Connecticut 13.5% (Rank
= 3rd). However, the impact of smoking can be excluded or minimized
as a risk factor for bladder cancer among Hispanic American men
living in the state of Connecticut and other risk factor must be
detected. Therefore, the secret for confirming the real risk factor of
invasive and in situ bladder cancer can be discovered in the state of
Connecticut among Hispanic American men. It is very important
to generate a new hypothesis about the reasons of bladder cancer
increase in the state of Connecticut among Hispanic American men
Figure 2, shows how one can identify the most important risk and
protective factors for invasive and in situ bladder cancer among
Hispanic American men living in the state of Connecticut.
In the Midwest of the United States,we have observed that
the highest overall age-adjusted incidence rates of invasive and
in situ urinary bladder cancer among White American men were
documented in the state of Detroit from 1999 to 2014.The most likely
reason for this rising age-adjusted incidence rate is that most White
American men living in the state of Detroit were likely more exposed
to a specific risk factor that may does not appear in the same race
living in the Midwest of the United States. However, multiple casecontrol
studies should be conducted to identify the most important
riskfactorsfor bladder cancer among White American men living in
the state of Detroit, comparing to the same race living in the state
of District of Columbia and New Mexico that were least affected by
invasive and in situ urinary bladder cancer Figure 3, shows how one
can identify the most important risk and protective factors for bladder
cancer among White American men living in the state of Detroit.
In the South of the United States,we have observed that the
highest overall age-adjusted incidence rates of invasive and in situ
urinary bladder cancer among White American men were observed
in the state of Delaware from 1999 to 2014.The most likely reason for
this rising age-adjusted incidence rate is that most White American
men living in the state of Delaware were more likely exposed to a
specific risk factor that may does not appear in the same race living in
the south of the United States. If we assume that smoking is the major
risk factor for bladder cancer among White American men in the
state of Delaware, then the smoking rate should be very high among
White American men, but the smoking rate was only 17.4% (Rank =
25th).However, the impact of smoking can be excluded or minimized
as a risk factor for bladder cancer among White American men living
in the state of Delaware, and another risk factor must be detected.
In addition, multiple case-control studies should be conducted to
identify the most important riskfactorsfor bladder cancer among
White American men living in the state of Delaware, comparing to
the same race living in the state of District of Columbia and New
Mexico that were least affected by invasive and in situ urinary bladder
cancer Figure 4, shows how one can identify the most important risk
and protective factors for bladder cancer among White American
men living in the state of Detroit.
The state of District of Columbia had the lowest overall ageadjusted
incidence rates of invasive and in situ urinary bladder
cancer among White American men from 1999 to 2014.The most
likely reason for this decreasing age-adjusted incidence rate is that
most White American men living in the state of District of Columbia
were less exposed to the major risk factor that contributing in the
increase of age-adjusted incidence rates of invasive and in situ urinary
bladder cancer.Therefore, the secret for confirming the real protective
factor of invasive and in situ bladder cancer can be detected in the
state of District of Columbia among White American men. It is very
important to generate a new hypothesis about the reasons of bladder
cancer decrease in the state of District of Columbia among White
American men.
In the West of the United States, we have observed that the
highest overall age-adjusted incidence rates of invasive and in situ
urinary bladder cancer among White American men were observed
in the state of Seattle from 1999 to 2014.The most likely reason for
this rising age-adjusted incidence rate is that most White American
men living in the state of Seattle were more likely exposed to a specific
risk factor that may does not appear in the same race living in the
west of the United States. If we assume that smoking is the major
risk factor for bladder cancer among White American men in the
state of Seattle, then the smoking rate should be very high among
White American men. However, if the smoking rate was not very
high among White American men living in the state of Seattle, then
the impact of smoking would be excluded or minimized as a risk
factor for bladder cancer and another risk factor must be detected.
In addition, multiple case-control studies should be conducted to
identify the most important riskfactorsfor bladder cancer among
White American men living in the state of Seattle, comparing to the
same race living in the state of District of Columbia and New Mexico
that were least affected by invasive and in situ urinary bladder cancer
Figure 5, shows how one can identify the most important risk and
protective factors for bladder cancer among White American men
living in the state of Seattle.
The state of New Mexico had the lowest overall age-adjusted
incidence rates of invasive and in situ urinary bladder cancer among
White American men from 1999 to 2014.The most likely reason
for this decreasing age-adjusted incidence rate is that most White
American men living in the state of New Mexico were less exposed to
the major risk factor that contributing in the increase of age-adjusted
incidence rates of invasive and in situ urinary bladder cancer.
Therefore, the secret for confirming the real protective factor of
invasive and in situ bladder cancer can be detected in the state of New
Mexico among White American men. It is very important to generate
a new hypothesis about the reasons of bladder cancer decrease in the
state of New Mexico among White American men.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Conclusion
Our study revealed that the state of Rhode Island, Detroit, Delaware, and Seattle are the best geographic areas in the United States of America, for studying the most important risk factors of invasive and in situ urinary bladder cancer among White American men. While, the state of District of Columbia, and New Mexico are the best geographic areas in the United States of America, for studying the most important protective factors of invasive and in situ urinary bladder cancer among White American men. The secret for confirming the real risk factor of invasive and in situ urinary bladder cancer can be found among Hispanic American men living in the state of Connecticut. The secret for confirming the real protective factor of invasive and in situ urinary bladder cancer can be found among White American men living in the state of District of Columbia, and New Mexico Therefore, multiple case-control studies adjusted by race and age should be conducted in the mentioned states to identify the major risk and protective factors that can be controlled.
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