• bladder cancer;
  • histopathology;
  • urothelial carcinoma of the bladder;
  • muscle-invasive bladder cancer;
  • non-muscle-invasive bladder cancer;
  • classification of bladder cancer;
  • TNM classification;
  • Stage;
  • Grade


  • To investigate Tumour-Node-Metastasis (TNM) stage and demographics at presentation in a very large, contemporary UK cohort of patients with bladder cancer and compare them with other published series, as little published data exists on the pathological characteristics of bladder cancer at presentation.

Patients and Methods

  • The British Association of Urological Surgeons (BAUS) Section of Oncology started a new urological tumour registry in 1998.
  • We performed a data analysis of all bladder cancer cases between 1999 and 2008.
  • Tumour TNM stage, grade and histopathological diagnosis were reviewed along with standard epidemiological data.


  • In all, 69 712 bladder cancer registrations were recorded. Complete T, N and M stage and grade was available for 32 240 patients.
  • The male to female ratio of the study population was 3:1 and the overall median (sd, range) age at presentation was 73 (11.6, 6–108) years.
  • Final pathological T staging showed that non-muscle-invasive bladder cancer accounted for 75% of cases with the remaining 25% being muscle-invasive disease. Of these patients, 8% had nodal disease and 4% other metastatic sites at presentation.
  • The tumour grade was G1–2 in 65% and G3 in 35% of cases. Transitional cell carcinoma (TCC) accounted for 92%, squamous cell carcinoma and adenocarcinomas 1.5% each, with 5% other histological variants.


  • Non-muscle-invasive TCC accounted for 75% of bladder cancer cases in the UK. The 1973 World Health Organization classification remains in widespread use amongst pathologists in the UK.
  • Obtaining complete and standardised staging and pathology reporting systems in bladder cancer remains a challenge.