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 bladdercancers are transitional cell carcinomas.
Objectives: To determine the epidemiologic features of urinary bladdercancer cases presenting at a cancer hospital, from Dec. 1994 through Dec. 2004.
Methods: Six-hundred andseven 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 donethrough the American Joint Commission on Cancer's criteria. Class of Case was established using the FacilityOncology 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 in17.3%, 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 in25.2%, 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. Majorityof the patients were symptomatic; smoking history was recorded mostly in men. Further, improving in stagingcould be useful in addressing the concerns about data reproducibility over time and use for surveillance purposes.