Carcinoma of the Urinary Bladder in a Tertiary Care Setting in a Developing Country

Background: Men have greater incidence and mortality rates than women for bladder cancer. Most bladder cancers are transitional cell carcinomas. Objectives: To determine the epidemiologic features of urinary bladder cancer cases presenting at a cancer hospital, from Dec. 1994 through Dec. 2004. Methods: Six-hundred and seven medical records were evaluated retrospectively at the Shaukat Khanum Memorial Cancer Hospital. Gender, age, histologic types, grade, stage, symptoms, risk factors, and patient follow-up were studied. Staging was done through the American Joint Commission on Cancer's criteria. Class of Case was established using the Facility Oncology Registry Data Standards, 2004. Results: Mean age: 55.5 years; men: 83%. Transitional cell- in 86%, squamous cell- in 4%, adeno- in 3%, and undifferentiated carcinoma in 7% of the cases. Stage: II in 18.3%, I in 17.3%, III in 14.2%, IV in 26%, 0 in 6.3%, and not evaluable in 17.8% of the cases. Grades: G3 in 37.9%, G2 in 25.2%, G1 in 9.7%, G4 in 2.8%, and undetermined in 24.4% of the subjects. Commonest presenting symptom: hematuria in 54.7% men and 52.9% women; risk factor: positive smoking history in nearly 35% males and 2% females. Average interval between diagnosis and last contact: 26.5 months; for analytic cases, 34.9 months. Conclusion: Urinary bladder cancer was seen primarily in males; transitional cell type was dominant. Majority of the patients were symptomatic; smoking history was recorded mostly in men. Further, improving in staging could be useful in addressing the concerns about data reproducibility over time and use for surveillance purposes.