OBJECTIVES: Urothelial carcinoma (UC) is a common type of cancer for which burden of illness is not well understood. A targeted literature review was performed in order to identify the current epidemiologic, humanistic, and economic burden of UC and metastatic UC (mUC), as well as identify potential evidence gaps within each topic.

METHODS: Literature published between January 2000 and November 2017 was identified by searching MEDLINE with MEDLINE^® E-pubs ahead of print, Embase, EconLit (Ovid SP^®), NHS Economic Evaluations Database. Relevant conference proceedings from the last 2 years were also included. The search strategy combined terms for bladder/UC with terms for advanced stage cancer and/or metastases, along with terms related to epidemiology, quality of life (QoL), and economic burden.

RESULTS: A total of 4,163 records were screened for inclusion; 50 publications, including eight abstracts, were included in the analysis. Most of these studies reported data on the epidemiology of mUC (n=32), followed by economic burden (n=10) and QoL (n=8). Incidence rates of mUC in the literature ranged from 2.8/100,000 in the US, based on the SEER database, to 3.8/100,000 based on GLOBOCAN in Japan and the EU-28. Locally advanced and metastatic disease was reported as a small proportion of the overall UC population (10%, T3; 6%, T4); median overall survival ranged from 3.88–19 months. While few studies reported humanistic burden, QoL was generally noted to be poor among patients with mUC. Furthermore, patients with UC were associated with significant healthcare costs. Total direct costs for T2-T4 ranged from $58,073 to $225,336 per patient per year for lifetime treatment.

CONCLUSIONS: There is a significant gap in the literature describing the burden of UC and mUC. Future research should focus on characterizing the epidemiology of mUC, with a breakdown by line of therapy, and elucidating the economic and humanistic burden within this population.