Dr Clinton on Differences in Bladder Cancer Incidence According to Gender

“It’s important to note that bladder cancer is more prevalent in men, and [that may be] why there is less of a recognition in women to instinctively think that maybe [symptoms] represent a bladder tumor, something more insidious than a urinary tract infection or overactive bladder symptoms. [This is why] first-line providers will instinctively test and treat for that whereas in men, when there is blood in the urine, [that] sets off red flags, because urinary tract infections should be relatively uncommon.”

Timothy N. Clinton, MD, an associate surgeon at Brigham and Women’s Hospital as well as a surgical oncologist at Dana-Farber Cancer Institute, discussed why the incidence of bladder cancer differs between male and female patients.

Clinton noted that bladder cancer remains more prevalent in men than women, which could be a contributing factor to the underdiagnosis of bladder cancer in female patients. Since female patients are more susceptible to urinary tract infections compared with men, many first-line providers will instinctively test and treat for these first as opposed to bladder cancer, he added. Comparatively, urinary tract infections are not common in men, therefore common signs and symptoms of the ailment such as blood in the urine are most associated with bladder cancer in these patients, he explained.

Beyond the anatomical differences between male and female patients, urinary storage differences can also contribute to differing bladder cancer incidence rates, Clinton said. Male patients are more likely to retain urine, which contains toxins associated with smoking or other environmental factors, he explained. Investigators have hypothesized that longer urine storage can induce mutational changes or damages that can lead to the development of a tumor, further suggesting that biological differences could partially account for the higher prevalence of bladder cancer in male patients, he concluded.