Introduction:

The National Cancer Institute SEER Program regularly publishes bladder-cancer specific survival statistics according to factors including age, sex, and race. However, these data are for all bladder cancers, and contemporary information specifically for NMIBC is difficult to obtain. Therefore, we quantified 5-year overall and bladder cancer-specific survival in a cohort of Department of Veterans Affairs (VA) patients diagnosed with NMIBC as part of planning a large VA surveillance trial.

Methods:

We used previously validated Natural Language Processing algorithms to identify a cohort of VA patients diagnosed with non-muscle invasive bladder cancer from the Corporate Data Warehouse who underwent a transurethral resection from 2003-2013. The patient demographics and Charlson Comorbidity Index were categorized. We then acquired the patients’ date of death from the Veterans Health Administration’s Death Ascertainment File and their cause of death from the Mortality Data Repository. We calculated Kaplan Meier estimates of survival with 99% confidence intervals.

Results:

A total of 27,008 patients were included. The patients in this study had a median age of 69, with a minimum age of 21 and a maximum age of 99. Almost all were male (n=26,683, 99%). The median comorbidity score was 4, with a minimum score of 0 and a maximum score of 21. The most prevalent comorbidity indicators included Chronic Pulmonary Disease (48.4%), Cancer other than Bladder (41%), and Diabetes without Chronic Complications (38.9%). This cohort was found to have a 5-year overall survival of 68% (99% CI 67%-69%) and a 5-year bladder cancer-specific survival of 93% (99% CI 92%-94%, Figure).

Conclusion:

The 5-year bladder cancer-specific survival in patients diagnosed with non-muscle invasive bladder cancer is substantially higher than the 5-year overall survival. This discrepancy may be related to the severity and number of comorbidities that patients in this population must manage. This warrants further research into the necessity of currently recommended high-intensity cancer surveillance for individuals with NMIBC, as this cancer diagnosis has a minimal impact on overall survival.

Funding: VA Cooperative Studies Program