CLINICOPATHOLOGIC FEATURES OF URINARY BLADDER CANCER AT A TERTIARY HOSPITAL IN WESTERN KENYA

Background Urinary bladder cancer is the ninth leading cause of morbidity and mortality globally, with a prevalence of 3% of all cancer diagnoses. Its local prevalence in Kenya is 1.89 per 100, 000 persons with previously documented studies describing it as a disease of the elderly. Local anecdotal data indicate that younger patients have begun presenting with bladder cancer. Objectives To establish the clinicopathological features of urinary bladder cancer. Methods A prospective descriptive hospital-based study among participants with bladder cancer at MTRH Urology department, sampled using a census sampling technique. Socio-demographic and clinical characteristics as well as predisposing factors were obtained through both interviews and a review of medical records. Disease staging was based on radiological imaging findings and histopathology reports. Statistical tests of association between socio-demographic characteristics, predisposing factors as well as the histological type, and Tumor, Node, Metastasis (TNM) stage of urinary bladder cancer were conducted using Pearson chi-square test with a critical value of ≤0.05. Results Forty-five (45) adults aged between 21 to 85 years with a mean age of 61.84 (±14.46) years and diagnosed with urinary bladder cancer were enrolled. Majority were male (68.9%; n=31) commonly presenting with painless hematuria, exposure to agrochemicals (60%; n=27), history of cigarette smoking (31.1%; n=14) with an average pack year of 9.43 (±6.198). The most common (71.1%; n=32) clinical stage was T 1 while 6.7% (n=3) had metastatic disease. More than half (55.6%) had stage I according to the TNM system while 91.1% had low-grade tumors. Transitional cell carcinoma (51.1%) was the most common histological type, followed by adenocarcinoma (29%), and squamous cell carcinoma (20%). Conclusions Patients diagnosed with bladder cancer in this study were mainly males with a mean age of 61.8 years. Majority of the participants had a history of smoking cigarettes or exposure to agrochemicals, and all presented with painless hematuria. Most patients had low-grade tumors diagnosed early.