11:15pm Sunday 13 October 2019

Doctors Can Miss Bladder-Cancer Symptoms in Older Women

Physicians tend to first treat older women for urinary-tract infections, so often women begin their cancer therapy later. That may lead to poorer outcomes, although several other factors may be involved.

Dr. Kyle Richards, assistant professor of urology at the UW School of Medicine and Public Health, analyzed Medicare data on more than 12,000 patients who were diagnosed with bladder cancer between 2007 and 2009.

It took physicians an average of 72 days to diagnose bladder cancer in women compared with about 59 days in men. Women went on to die of the bladder cancer at a rate of 15.2 percent compared with 10.4 percent for men. Women who sought care with urinary-tract infection diagnosis at their first visit waited longest for a correct diagnosis compared with those who had other symptoms, such as blood in the urine.

“We think women with bladder cancer have worse cancer outcomes than men with bladder cancer in part due to the time spent evaluating and treating them for their urinary-tract infections,” says Richards. “Physicians should consider that urinary-tract infections or irritative urinary symptoms such as urgent urination, frequent urination, or painful urination could be a warning of undiagnosed bladder cancer in older patients. The implication for patient care is that if irritative urinary tract symptoms persist despite a short course of conservative treatment, urologic referral should be considered.”

Richards says more research is needed to know whether the worse outcomes for patients are due to different tumor biology in those who also have true urinary-tract infections, lack of awareness of bladder cancer, slower time to treatment, or a combination. His collaborators on the study were Sandra Ham, and Drs. Joshua A. Cohn and Gary D. Steinberg, all of the University of Chicago Medical Center.

University of Wisconsin School of Medicine and Public Health

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