Cancer of the urinary bladder was the fourth most common cancer diagnosed among men in the SRRHIS region during 1991 through 1993. The bladder cancer incidence rate was much higher for men than women, and the rate for white men was over twice as high as for black men (all SRRHIS white males: 25.4 per 100,000; black males 11.3). These rates are consistent with Atlanta and SEER data, although lower for both races in the SRRHIS region. The rates for females are considerably lower, with white females showing higher rates than black (white females: 8.3; black females: 4.8)(Figure 2).

Cigarette smoking is believed to account for a substantial proportion of bladder cancers in men and women. Other risk factors are exposures concentrated in certain occupational settings including dye workers, rubber workers, leather workers, painters, truck drivers and aluminum workers. Ionizing radiation may also be related to increased bladder cancer risk (Miller, 93).

Survival rates reported by the SEER program show fairly dramatic differences in survival by race. Five year relative survival rates for all stages are 84% for white men, 64% for black men, 75% for white women, and 51% for black women. For persons with localized disease at diagnosis survival rates are 95% for white men, 78% for black men , 89% for white women, and 80% for black women (Kosary, 95). In the SRRHIS region whites were much more likely to be diagnosed with early localized or in situ tumors (79%) than were blacks (59%)(Figure 3).

Bladder cancer is the only type of cancer in which in situ tumors are combined with invasive tumors to describe the extent of disease in the population, following the convention used by the SEER program in reporting bladder cancer rates. The SEER program combines in situ and invasive tumors in rate calculations because of problems in ascertaining from the medical record the level of invasion of early bladder tumors, probably because in situ and microinvasive tumors receive similar treatment. Of the 482 bladder tumors reported in the SRRHIS population, 81 were considered in situ at diagnosis.