ABSTRACT
Bladder cancer is a global disease, with 540,000 incident cases and 188,000 deaths in 2015 worldwide. The incidence and prevalence of bladder cancer increases with age. The average age of diagnosis is 73 in the United States (US) with approximately 9 of 10 patients diagnosed after the age of 55. Age specific incidence rates rise gradually around age 50–54 in both males and females, with a sharper rise in males age 60–64. Tobacco smoke is full of aromatic amines, as are other environmental carcinogens implicated in bladder cancer. Occupational exposures account for between 5 and 10% of all bladder cancer. Occupations that work directly chemicals and dyes have the greatest lifetime risk. Painless gross hematuria is present in 85% of patients with newly diagnosed bladder cancer, and microscopic hematuria is present in nearly all patients. A full hematuria evaluation for bladder cancer includes a focused history and physical, cystoscopy, upper tract imaging, and a urine culture.
