Bladder cancer is the fifth most commonly diagnosed noncutaneous malignancy in the US, and the second most prevalent among middle-aged and elderly men. Methods of detection, prevention and treatment have hardly changed over the past 20 years, as, consequently, has the likelihood of dying from this disease; new approaches are desperately needed.

Increased basic, translational, clinical and health services research will be needed to devise strategies that can be brought to clinical fruition, which will in turn depend on attracting the best scientists into bladder cancer research. The NIH has, however, cut research support for bladder cancer by 7%, while it increased funding for the other ten most commonly diagnosed malignancies by 4–100% between 2002 and 2005. In 2005, bladder cancer research received the lowest funding per new case, one of the lowest per cancer-associated death, and was the subject of the fewest clinical trials of all the common cancers. Ironically, a huge amount is still spent on bladder cancer because it is the most expensive malignancy to treat per patient over their lifetime. An ounce of prevention (or research on prevention) would, therefore, certainly be worth a pound of cure.