Carcinoma of the urinary bladder in a tertiary care setting in a developing country

Objectives: To determine the epidemiologic features of urinary bladder cancer cases presenting at a cancer hospital, from Dec. 1994 through Dec. 2004. Patients and 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%, G3 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, a change in the staging system to the Collaborative Staging methodology would be useful in addressing the concerns in the public health sector about data reproducibility over time and to use it for surveillance purposes.