To characterize the changes in variant bladder cancer (VBC) diagnosis over time using a national retrospective cohort, highlighting its clinical implications.
Key Findings:
The diagnosis of VBC increased from 3.5% in 2004-2009 to 4.3% in 2016-2021 (p < 0.001), a 22.5% relative rise, indicating a significant trend.
Increases were concentrated in micropapillary, sarcomatoid, and neuroendocrine subtypes (p < 0.001), suggesting a shift in diagnostic focus.
No significant change was observed in squamous differentiation diagnosis (p = 0.20), indicating stability in this subtype.
The increase in VBC diagnosis was noted across all facility types, emphasizing the widespread recognition of this cancer variant.
Interpretation:
The rising trend in VBC diagnosis suggests improvements in recognition and reporting of this aggressive cancer subtype, particularly in specialized cancer centers, which may enhance patient outcomes.
Limitations:
The study relies on retrospective data, which may have inherent biases, including selection bias.
Variability in pathologist interpretation may affect diagnosis accuracy, potentially leading to underreporting or misclassification.
Conclusion:
The diagnosis of VBC is increasing nationally, particularly among certain aggressive subtypes, highlighting the need for centralized reviews in cancer diagnosis to improve accuracy and patient care.
by Syed N. Rahman, Kandala Keervani, Xiwen Zhao, Curtis J. Perry, Ping Mu, Darryl Martin, Wei Shen Tan, David G. Hesse, Daniel P. Petrylak, Joshua Warrick, Deepika Kumar, Peter A. Humphrey, Fady Ghali
