FOUR IN FIVE AGED 55 AND OVER ARE UNAWARE OF BLADDER CANCER AND ITS SYMPTOMS DESPITE BEING MOST AT RISK

• 82% of people aged over 55 across the UK and Ireland know little to nothing about bladder cancer despite age being one of the biggest risk factors.
• 37% of people in ‘high risk’ professions, including hairdressers, plumbers, and painters, would not seek medical advice if their urine was brown or red, a key symptom which could indicate the presence of blood.
• These results are part of a bladder cancer awareness survey of more than 4,000 people conducted by Merck as part of Bladder Cancer Awareness Month which takes place over May.

4th July 2024: In a revealing survey commissioned and funded by Merck Healthcare, it emerged that a staggering four in five (82%) people aged 55 and older are largely uninformed about bladder cancer, despite being among those most at risk. Age is a significant risk factor for the disease, second only to smoking, with over 70% of bladder cancer cases found in individuals over 65.

The survey – which is the largest bladder cancer awareness survey conducted in the UK and Ireland - highlighted a stark contrast in awareness levels across age groups, with older adults being far less aware than their younger counterparts aged 18-34 (60%) and 35-54 (70%). This lack of awareness spreads across all groups in the UK and Ireland, with more than seven out of ten (71%) people admitting they know little to nothing about bladder cancer. These insights underscore a critical need for better education and awareness across all age groups, particularly those most vulnerable.

The survey, commissioned and funded by Merck, with advice from the patient groups World Bladder Cancer Patient Coalition and Fight Bladder Cancer, asked more than 4,000 people in the UK and Ireland what they know about the disease and its symptoms as part of ‘Bladder Cancer Awareness Month’ which takes place throughout May.

Cause for concern

The results are likely to cause alarm among experts after bladder cancer moved up from the 10th to the 9th most diagnosed cancer worldwide and the 5^th most common in Europe.^1,2 It is known as one of the more challenging cancers to experience and to treat, with one of the highest recurrence rates in cancer of up to 80%³ and a mortality rate of up to 50%³ for invasive bladder cancer. Both incidence and mortality rates are also increasing; more than 10,000 people in the UK are diagnosed with the disease each year, with 15 related deaths every day (2017-2019).⁴

At risk occupations

Certain occupations working with or near cancer-causing chemicals have been associated with a higher risk of bladder cancer, for example:

• Factory workers who are exposed to cancer-causing chemicals have been found to be 16 times more likely to be diagnosed with bladder cancer compared to people in other occupations⁵
• Even hairdressers have a 30-35% higher risk of bladder cancer compared to the general public[1]^,[2]

Despite the increased risks, those working in ‘high risk’ occupations as hairdressers, plumbers, and painters are much less likely to contact their GP for bladder cancer symptoms, according to the survey, revealing a concerning risk that could lead to the quiet progression of this common yet often overlooked cancer. 

The survey found that one in three (37%) people in higher risk industries would not seek medical advice for brown or red urine, a key symptom which could indicate the presence of blood, compared to 17% of the general population. Worryingly, almost two in three (68%) people in higher risk industries would not seek medical advice for a lump in their pelvic area compared to 41% of the general population.

"These findings are a wake-up call for the urgent need for increased public education on bladder cancer symptoms, particularly amongst those at higher risk due to their age or profession" said Dr Stuart Hill, Medical Director UK and Ireland at Merck Healthcare. "Merck has conducted research and provided education in bladder cancer for many years and we have seen first-hand not only the pain and suffering it causes patients and loved ones, but also how the area is affected by low public awareness. We hope that by sharing these powerful findings, more people might know the signs and symptoms and feel confident to seek help, particularly as early detection is crucial to successful treatment.”

Barriers to seeking help

The survey also delved into why people might hesitate to seek medical treatment for bladder cancer, uncovering some telling reasons. A number of respondents 44% of said they were put off by the difficulty of getting a GP appointment. Close behind, 43% of those surveyed admitted they didn't believe their symptoms were serious enough to warrant medical attention. Additionally, 30% were discouraged by the prospect of long waiting times.

Also, stigma was indicated as a key barrier to people seeking help for worrying symptoms, with those in higher risk industries being significantly more likely to delay seeking advice due to embarrassment and fear of tests. Only half of people in higher risk industries are confident to talk to a GP about potential bladder cancer symptoms, with an even lower 10% feeling confident talking to their employer.  

“Bladder cancer is recognised as the ‘Cinderella of cancers’ because it is less high profile compared with other cancers. It does not receive the same public support or advocation from important stakeholders,” said Prof. Ananya Choudhury, Clinical Oncologist at the Christie NHS Foundation Trust. “It is important to start conversations with people with limited exposure to and awareness of bladder cancer wherever and whenever possible.”

“The level of bladder cancer awareness in the UK is really low,” said Dr Lydia Makaroff, Chief Executive of Fight Bladder Cancer. “We see so many people who are diagnosed with bladder cancer who’ve never heard of it, who feel that they’re alone and feel like they don’t know anyone else affected by the disease. The most significant barrier to raising awareness of bladder cancer is stigma, and we see many people who are very afraid about speaking about bladder cancer. If you notice any symptoms always speak to your GP, inform them about your occupation, and remember it is perfectly acceptable to insist on a blood test for bladder cancer or to seek a second opinion.” 

“Bladder Cancer awareness is low in the UK, and we need to try and change the stigma related around being diagnosed,” said Emma-Jayne Kelly, Urology Clinical Nurse Specialist (CNS) at The Clatterbridge Cancer Centre NHS Foundation Trust. “It is not one of the more common cancers that people are aware of but is definitely on the rise. Encouragement to seek medical advice early if they have any symptoms of concern is key to better outcomes. Patients will always be fully supported throughout their journey to the highest level.”

According to projections from The Health Foundation, cases of bladder cancer are expected to increase by around 50% in the UK over the next two decades, due to factors such as an ageing population and lifestyle changes. In response to this growing need to help people with bladder cancer manage the condition, Merck Healthcare have launched a patient app in collaboration with digital health company Huma, designed to support and empower those affected by bladder cancer in the UK through a digital-first approach to treatment and care. 

Dr. Stuart Hill, highlights the significance of this initiative: "Our collaboration with Huma represents a pivotal step forward in addressing the challenges faced by bladder cancer patients. Being diagnosed with bladder cancer is the start of a long and complex journey and patients only have so much time with their doctors; by harnessing the power of digital technology, we aim to revolutionise the way patients are supported to understand, track and manage their condition, to ultimately improve treatment outcomes." 

This app has been designed in collaboration with healthcare professionals in the NHS and leading patient organisations to offer patients reliable, personalised advice, treatment reminders, symptom tracking and information. It allows patients to track their symptoms and manage their medication, with the option to share this with their clinicians during appointments. Crucially, upon the advice from the NHS and patient groups, the app offers caregiver access for dual management of the patient’s journey and to ensure maximum accessibility for patients and loved ones.  

If you have experienced any of the symptoms listed below, or are worried about cancer symptoms, you should go and speak to your GP as soon as you can. If you require any assurance on contacting the GP you can speak to a pharmacist in the first instance.   

• Red or brown urine
• Frequent urination or increased urgency during the daytime
• Repeated Urinary Tract Infection (UTI) or cystitis
• Increased night time urination
• Pelvic pain
• Fatigue
• Significant unexplained weight loss
• Frequent or persistent fevers
• Regular headaches
• Finding a lump on your pelvic area
• Persistent coughing
• Chest pain

For more information about bladder cancer and which occupations are higher-risk due to cancer-causing chemical exposure, please visit: https://fightbladdercancer.co.uk/get-help/signs-and-symptoms  

[1] Action Bladder Cancer. The Facts About Bladder Cancer. Available at: https://actionbladdercanceruk.org/the-facts-about-bladder-cancer/ [last accessed May 2024]Harling M, Schablon A, Schedlbauer G, et al. Bladder cancer among hairdressers: a meta- analysis(link is external). Occup Environ Med. 2010 May;67(5):351-8.

[2] Takkouche B, Regueira-Méndez C, Montes-Martínez A. Risk of cancer among hairdressers and related workers: a meta-analysis(link is external). Int J Epidemiol. 2009 Dec;38(6):1512-31.