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BC number and treatment advances Bladder Cancer (BC) is not a very common malignancy. In Brazil, there are 10.640 new cases estimated for 2020, representing 1.6% of all malignancies (1, 2). In Brazil, aging population has been associated with a significant increment in the number of patients with BC during the last decade (3). During this period, an increment of 44% in the number of hospital admissions due to BC have occurred (3). Apart from that, unfortunately, treatment of the initial phases of BC is complex and underperformed in the public health system (SUS) (4). The main reasons are the limited access to the initial evaluation, diagnosis, initiation of treatment, and treatment availability, resulting in a significant number of patients with more advanced disease (3). BCG shortage is another worldwide problem associated with more disease progression to advanced disease. Fortunately, during the last years, we have witnessed significant advances in new treatments for this disease. Immunotherapies, targeted therapies, diagnostic and staging tests, and several local technologies have been associated with lifespan and quality of life improvements for these patients (5). In the last three years, five immunotherapies (avelumab, atezolizumab durvalumab, pembrolizumab, and nivolumab) and one targeted therapy (erdafitinib) have been approved for the treatment of patients with BC (5). These medications can now be used in a variety of scenarios, from non-muscle invasive to first-line metastatic, maintenance or second-line metastatic treatments. Furthermore, there are also new medications being approved (5, 6). There is no doubt that we can now treat these BC patients better and better.

Increasing costs from bladder cancer in the Brazilian Health System: the role of establishing public health policies