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Harrison's Principles of Internal Medicine, 18e
| Part 7. Oncology and Hematology > Section 1. Neoplastic Disorders > |
Chapter 94. Bladder and Renal Cell Carcinomas
Sections: Bladder Cancer, Carcinoma of the Renal Pelvis and Ureter, Renal Cell Carcinoma, Further Readings.
Topics Discussed: pathophysiology of neoplasia; urologic disorders.
Excerpt:"A transitional cell epithelium lines the urinary tract from the renal pelvis to the ureter, urinary bladder, and the proximal two-thirds of the urethra. Cancers can occur at any point: 90% of malignancies develop in the bladder, 8% in the renal pelvis, and the remaining 2% in the ureter or urethra. Bladder cancer is the fourth most common cancer in men and the thirteenth in women, with an estimated 70,530 new cases and 14,680 deaths in the United States predicted for the year 2010. The almost 5:1 ratio of incidence to mortality reflects the higher frequency of the less lethal superficial variants compared to the more lethal invasive and metastatic variants. The incidence is three times higher in men than in women and twofold higher in whites than blacks, with a median age at diagnosis of 65 years.Cigarette smoking is believed to contribute to up to 50% of the diagnosed urothelial cancers in men and up to 40% in women. The risk of developing a urothelial malignancy in male smokers is increased two- to fourfold relative to nonsmokers and continues for 10 years or longer after cessation. Other implicated agents include the aniline dyes, the drugs phenacetin and chlornaphazine, and external beam radiation. Chronic cyclophosphamide exposure may also increase risk, whereas..."
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