Cancer By County
Bladder Cancer3-6

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Risk Factors

Cigarette smoking is the most important established risk factor for bladder cancer; cigarette smokers develop bladder cancer at two to three times the rate as nonsmokers. The risk increases with the number of packs per day smoked. Smoking is estimated to cause 47 percent of the bladder cancer deaths among men and 37 percent among women in the U.S. Workers exposed to certain chemicals are also at increased risk of bladder cancer; these chemicals include:
4-aminobiphenyl (workers in the production of 2-aminobiphenyl), aromatic amines such as benzidine (workers in the production of benzidine and benzidine-based dyes and in the garment, leather, rubber manufacturing, polyurethane foam manufacturing, printing, paper and homecraft industries), 2-naphthylamine (laboratory technicians and scientists using it in research), and polycyclic aromatic hydrocarbons from engine exhaust, smelting, and roofing. Other occupations with an increased risk are painters, aluminum workers, machinists, hairdressers, and truck and other motor vehicle drivers. Occupational exposures have been estimated to cause approximately 23 percent of bladder cancers. People living in urban areas are at higher risk of bladder cancer.

Studies of artificial sweeteners have not shown these substances to increase the risk of bladder cancer. The studies of coffee drinking are inconsistent, with some studies showing an association with bladder cancer and others not. Other factors that may cause bladder cancer are bladder infection with a parasitic fluke (Schistosoma haematobium), treatment with the anti-cancer drugs chlornaphazine and cyclophosphamide, long-term use of pain killers containing phenacetin, urinary tract infections and stasis (slowed or stopped flow of urine), dietary factors, tobacco other than in cigarettes, and genetic susceptibility.

Prevention and Control

Not smoking cigarettes and minimizing exposure to hazardous chemicals in the workplace are the best means of preventing bladder cancer. There is no routine screening test for the early detection of bladder cancer.

Incidence and Mortality in the U.S.

Bladder cancer is the sixth most common type of cancer in the U.S. with 54,400 new cases estimated for 1998. The incidence is much greater in men than women and greater among white than black men. Nationally, bladder cancer incidence increased about ten percent between 1973 and 1991. The increase was much greater for black men and women. For 1998, 12,500 deaths due to bladder cancer have been estimated. The five-year survival rate for bladder cancer increased since the 1960s, to 80 percent for whites and 60 percent for blacks. If diagnosed at the localized stage, the five-year survival rate for bladder cancer is 94 percent.

Incidence in New Jersey - 1986-1996

Tables 6 through 9 contain data on the incidence of bladder cancer in New Jersey by county from 1986 to 1996. Figure 5 shows the trends over time in the statewide incidence rates. Statewide, white males had a much higher rate than black males, white females, or black females (see Figure 5). All the counties followed a similar pattern (see Table 9). Statewide, the rates for each race/gender group remained fairly steady over the years, although the rates generally increased for black males and decreased for black females (see Figure 5).

Conclusion

Reducing smoking and minimizing exposure to carcinogens in the workplace should be continued in order to reduce the rates of bladder cancer.

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Table 6.
Bladder Cancer Incidence
By County, White Males, New Jersey - 1986-19961

COUNTY

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996
(Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

31

30.7

35

35.0

42

40.5

46

44.7

45

44.1

42

39.2

56

50.4

45

39.9

37

32.3

44

40.3

45

40.7

Bergen

163

35.9

198

43.5

192

41.2

196

42.7

182

38.8

188

40.6

192

40.7

204

42.4

172

35.8

155

32.0

178

36.6

Burlington

54

37.7

43

29.4

67

45.4

53

34.8

75

46.9

67

43.0

69

43.3

63

39.8

56

34.9

73

44.5

63

37.4

Camden

63

31.7

79

40.0

82

41.1

79

37.9

86

41.7

70

33.8

85

42.1

79

37.6

78

37.8

82

39.8

83

39.1

Cape May

21

33.2

22

33.7

31

43.3

28

41.0

25

37.3

26

37.9

23

34.4

25

35.0

29

40.0

34

46.2

22

31.2

Cumberland

20

33.1

23

36.1

19

32.3

21

33.8

19

30.1

17

24.9

25

39.4

16

25.0

25

38.6

24

40.1

20

29.4

Essex

99

34.5

88

31.7

98

36.2

103

37.9

102

39.6

92

35.5

103

40.5

100

38.4

87

33.9

80

31.1

76

31.6

Gloucester

22

27.0

33

40.2

32

37.3

40

45.6

34

39.0

37

39.1

44

45.9

40

42.3

39

39.2

31

32.2

36

36.7

Hudson

92

38.8

93

39.3

102

42.7

86

36.6

66

29.0

103

44.6

81

34.2

81

34.7

81

34.9

78

33.1

73

31.2

Hunterdon

10

24.6

13

31.1

17

39.9

15

32.6

21

45.4

17

37.1

11

21.5

14

28.3

11

20.1

13

24.6

14

27.5

Mercer

45

33.7

56

40.8

55

40.2

62

44.5

61

44.3

51

37.2

58

40.6

53

37.9

53

38.1

62

44.0

59

41.7

Middlesex

107

39.0

97

34.0

109

39.5

104

35.6

103

35.3

107

37.2

116

38.7

123

39.7

111

36.5

114

36.7

104

33.7

Monmouth

104

43.2

79

32.0

116

46.5

95

37.5

96

37.9

87

33.6

111

42.5

108

40.1

108

40.2

106

38.8

95

33.1

Morris

66

38.0

67

36.8

68

37.4

58

32.2

70

38.3

52

28.3

68

36.4

82

43.6

67

34.9

78

39.6

79

40.4

Ocean

133

42.5

138

43.3

151

46.9

135

42.2

153

43.2

150

45.1

151

43.6

164

45.0

136

36.9

160

40.0

134

33.9

Passaic

90

43.9

88

42.4

85

41.5

64

31.9

83

40.5

64

31.9

82

40.3

75

37.7

89

43.5

88

41.6

71

34.3

Salem

8

25.9

9

27.9

11

34.7

14

43.1

19

59.9

21

66.3

10

29.9

14

44.3

5

14.6

14

44.6

11

30.6

Somerset

26

28.8

32

32.5

46

45.0

42

43.1

35

32.8

31

30.3

28

26.5

33

29.4

26

23.3

36

30.6

30

25.1

Sussex

24

49.4

13

27.2

26

54.9

13

25.3

16

30.5

23

47.0

20

38.0

22

42.3

20

37.4

21

38.1

21

41.3

Union

101

40.6

99

39.9

113

45.1

85

33.5

80

32.6

92

38.0

98

39.4

80

32.0

79

31.0

83

33.5

77

30.4

Warren

16

37.7

20

46.6

22

49.0

13

28.7

16

34.4

28

59.3

25

54.3

30

64.4

15

29.7

24

50.4

20

42.1

STATE

1296

37.4

1325

37.8

1485

42.0

1354

38.1

1388

38.8

1366

38.0

1457

40.0

1451

39.1

1324

35.7

1400

37.0

1311

34.6


1Incidence rates - per 100,000 males, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Source: New Jersey State Cancer Registry.

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Table 7.
Bladder Cancer Incidence
By County1, White Females, New Jersey - 1986-1996

COUNTY

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996 (Prelim.)

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

No.

Rate

Atlantic

13

10.1

17

11.2

11

7.2

16

10.8

18

10.7

13

7.8

10

6.8

14

9.5

15

9.9

12

8.4

20

12.2

Bergen

72

11.4

73

11.4

62

9.9

73

11.9

67

10.3

71

10.4

82

13.1

73

10.9

60

8.8

61

9.1

67

10.7

Burlington

23

11.5

9

4.3

16

7.4

20

9.4

24

11.0

25

12.8

19

8.7

23

11.1

21

10.1

21

9.8

19

9.1

Camden

32

11.1

30

10.5

29

9.2

30

9.9

25

7.8

37

12.2

31

10.4

45

16.0

33

11.5

23

7.0

35

11.5

Cape May

---

---

13

13.5

12

13.6

7

8.5

13

12.5

11

10.5

6

8.1

11

10.9

13

13.8

9

9.8

11

11.1

Cumberland

10

10.8

---

---

7

8.2

11

11.1

9

9.3

8

8.9

12

12.8

9

12.1

7

8.6

5

6.4

6

7.4

Essex

37

9.0

30

6.5

39

9.8

38

9.8

32

8.5

44

11.7

35

9.6

46

11.7

32

8.3

35

8.7

45

12.9

Gloucester

13

12.6

7

6.3

9

7.2

12

8.9

6

4.9

17

12.6

15

11.6

6

5.1

16

12.6

9

7.3

7

5.1

Hudson

40

10.5

38

9.8

36

10.3

36

9.6

32

8.4

35

9.0

43

12.2

27

7.7

37

9.7

38

10.7

33

9.4

Mercer

12

6.4

10

5.4

18

8.7

15

7.1

28

15.1

29

14.3

25

12.4

15

8.2

21

10.6

23

12.3

17

10.1

Middlesex

39

10.8

26

7.3

39

10.4

42

11.0

37

9.4

31

7.9

41

10.9

31

7.4

40

10.0

48

11.7

36

8.6

Monmouth

26

7.2

36

9.5

27

8.1

32

9.2

47

13.2

35

9.9

41

11.4

37

9.2

41

12.3

42

11.3

28

6.5

Morris

25

9.9

22

9.0

22

8.4

16

5.9

30

11.0

26

9.3

32

13.4

28

9.7

21

8.0

20

7.5

24

9.0

Ocean

41

9.5

36

8.2

50

10.8

58

12.5

45

12.2

57

11.2

55

11.9

57

11.4

36

6.1

55

12.2

52

9.0

Passaic

30

8.9

33

10.5

35

11.1

32

9.5

35

11.3

15

5.2

29

9.6

16

5.0

29

9.5

25

8.8

30

8.7

Somerset

16

12.6

14

11.0

12

8.5

11

8.6

12

8.9

9

5.8

12

7.5

14

8.5

10

6.4

14

8.2

10

6.7

Sussex

6

10.0

8

13.5

---

---

---

---

---

---

5

7.2

8

10.3

6

8.7

15

21.3

---

---

9

13.5

Union

27

7.3

19

5.0

29

8.6

35

8.8

37

10.5

36

10.1

34

9.0

31

8.4

34

9.8

37

9.4

29

8.8

Warren

6

10.4

6

8.0

---

---

7

9.4

7

10.3

7

11.5

---

---

---

---

11

13.9

12

13.1

8

9.1

STATE

483

9.8

437

8.6

466

9.3

501

9.9

515

10.1

514

9.9

537

10.7

503

9.7

501

9.6

502

9.6

495

9.4


1Incidence rates - per 100,000 females, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with six or more years of fewer than five cases each year were removed from the table - Hunterdon and Salem counties. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.

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Table 8.
Bladder Cancer Incidence
By County, Blacks By Gender, New Jersey - 1986-1990 And 1991-19961

COUNTY

1986-1990

1991-1996

MALE

FEMALE

MALE

FEMALE

Number

Rate2

Number

Rate2

Number

Rate2

Number

Rate2

Atlantic

13

17.1

11

8.5

15

13.7

12

6.6

Bergen

19

25.9

8

6.8

12

12.5

7

4.2

Burlington

18

27.9

5

6.2

17

15.3

10

8.2

Camden

13

11.2

14

8.2

35

19.4

15

5.9

Cape May

5

46.9

5

35.2

---

---

---

---

Cumberland

6

18.7

---

---

---

---

---

---

Essex

64

13.2

53

6.8

98

16.0

45

4.6

Gloucester

7

18.3

---

---

9

15.0

---

---

Hudson

14

15.3

18

11.6

23

17.5

12

5.8

Mercer

11

10.5

9

6.4

24

17.1

8

4.1

Middlesex

14

22.2

8

9.6

8

9.0

6

5.3

Monmouth

9

10.1

8

6.1

22

17.0

---

---

Passaic

10

11.2

8

6.6

21

19.2

7

3.9

Salem

---

---

---

---

---

---

7

19.2

Somerset

---

---

---

---

9

36.1

---

---

Union

25

17.0

9

4.4

35

19.5

25

8.7

STATE

237

15.2

173

7.3

345

16.2

167

5.2


1Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. Counties with fewer than five cases for each gender in each time period were removed from the table - Hunterdon, Morris, Ocean, Sussex, and Warren counties. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.
2Average annual rate.

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Table 9.
Bladder Cancer Incidence
By County, Race And Gender, New Jersey - 1986-1996 Combined1

COUNTY

MALE

FEMALE

WHITE

BLACK

WHITE

BLACK

Number

Rate2

Number

Rate2

Number

Rate2

Number

Rate2

Atlantic

468

40.0

28

15.1

159

9.5

23

7.4

Bergen

2020

39.0

31

18.2

761

10.7

15

5.3

Burlington

683

39.8

35

20.3

220

9.5

15

7.4

Camden

866

38.3

48

16.0

350

10.7

29

6.9

Cape May

286

37.5

9

36.8

109

10.6

6

16.4

Cumberland

229

33.2

8

10.4

88

9.1

6

5.3

Essex

1028

35.3

162

14.8

413

9.6

98

5.5

Gloucester

388

38.7

16

16.1

117

8.5

5

3.6

Hudson

936

36.3

37

16.5

395

9.7

30

8.3

Hunterdon

156

30.1

---

---

44

6.7

---

---

Mercer

615

40.4

35

14.5

213

10.0

17

5.1

Middlesex

1195

37.0

22

14.3

410

9.7

14

7.1

Monmouth

1105

38.6

31

14.1

392

9.8

12

3.8

Morris

755

36.9

5

13.0

266

9.2

---

---

Ocean

1605

41.9

5

14.4

542

10.4

6

11.0

Passaic

879

39.1

31

15.9

309

8.9

15

5.0

Salem

136

38.5

5

9.5

41

8.3

9

13.9

Somerset

365

31.3

12

28.9

134

8.4

---

---

Sussex

219

38.9

---

---

69

9.6

---

---

Union

987

35.9

60

18.5

348

8.7

34

6.9

Warren

229

44.5

---

---

72

9.2

---

---

STATE

15157

38.0

582

15.8

5454

9.7

340

6.1


1Incidence rates - per 100,000 population, age-adjusted to the 1970 U.S. standard population. Cases of unknown county are included in the State numbers and rates. The dashes indicate fewer than five cases. Source: New Jersey State Cancer Registry.
2 Average annual rate.

Figure 5.
Bladder Cancer Incidence
by Gender and Race, New Jersey, 1986-1996

Figure 5

*1996 data are preliminary. Source: New Jersey State Cancer Registry