Bladder Cancer: A Major Public Health Issue
Bladder Cancer: A Major Public Health Issue
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DOI：
10.1016/j.eursup.2008.04.001
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发表时间：
2008-07-01
影响因子：
--
通讯作者：
Grasso, Marco
中科院分区：
文献类型：
--
作者：
Grasso, Marco
目的：本文考虑了膀胱癌的流行病学、社会负担和自然史;早期诊断的常见障碍;以及可能阻碍检测疾病职业原因的专业和临床因素。数据和信息来自于对过去6个月发表的文献的综述（通过PubMed数据库）和作者诊断和治疗膀胱癌的临床经验。用于检索文献的关键词为“膀胱癌”、“流行病学”、“发病率”、“死亡率”和“费用”。结果：膀胱癌是一种常见的恶性肿瘤，特别是在欧洲和北美，男性和白色人群中;然而，在一些医生中以及在一般人群中，对这种疾病的早期症状的认识水平很低。膀胱癌是昂贵的，复发率高，需要终身随访。许多膀胱癌病例与工作场所致癌物暴露有关，但由于怀疑指数低、病史记录不充分、潜伏期、缺乏暴露影响数据以及职业卫生服务转诊率低，职业原因往往被遗漏。早期诊断是有效治疗的关键，因为晚期疾病很可能会进展或复发。结论：膀胱癌的负担可以通过早期诊断，这取决于公众和专业人士对症状的认识，其次是早期干预来减少。职业风险因素尚未完全了解，也没有共同的国际议定书来界定接触风险。(C)2008年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Objectives: This paper considers the epidemiology, societal burden, and natural history of bladder cancer; the common barriers to early diagnosis; and the professional and clinical factors that can impede the detection of an occupational cause of the disease.Methods: The data and information derive from a review of the literature published over the past 6 mo (via the PubMed database) and from the author's clinical experience with the diagnosis and management of bladder cancer. Keywords used to search the literature were "bladder cancer,'' "epidemiology,'' "incidence,'' "mortality,'' and "cost.'' Only articles published in English were considered.Results: Bladder cancer is a common malignancy, particularly in Europe and North America, in men, and in white populations; however, there is a low level of awareness among some doctors as well as in the general population of the early symptoms of the disease. Bladder cancer is costly with a high recurrence rate and a requirement for lifelong follow-up. Many cases of bladder cancer are associated with exposure to workplace carcinogens, but occupational causes are often missed as a result of a low index of suspicion, inadequate documentation of history, latency, lack of data on exposure effects, and a poor rate of referral to occupational health services. Early diagnosis is the key to effective treatment because advanced disease is likely to progress or recur.Conclusions: The burden of bladder cancer can be reduced through early diagnosis, which depends on public and professional awareness of the symptoms, followed by early intervention. Occupational risk factors are not yet completely understood, and there are no shared international protocols aimed at defining exposure risks. (C) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.