Pattern of bladder cancer at University Teaching Hopital,lusaka,Zambia in the era of HIV epidemic

Abstract

Background: Human Immunodeficiency Virus (HIV) is endemic to Zambia and is associated with changes in the patterns of both AIDS and non- AIDS defining cancers. Bladder cancer is one malignancy that has been noted to increase in the era of HIV/ AIDS epidemic. This study sought to describe the pattern of cancer of the bladder at UTH in the era of HIV/AIDS epidemic in respect with the epidemiological characteristics, prevalence of HIV infection and the histological types of bladder cancer in patients with cancer of the bladder. Patients and Methods: A prospective cross sectional, hospital based study was performed at the University Teaching Hospital (UTH), Lusaka, Zambia, between November 2009 and November 2010. Patients with bladder cancer who presented to the hospital during this period were recruited and parameters studied included patients demographics, clinical presentation, HIV status and pathology of cancer. Data collected was analyzed using SPSS 17. Results: A total of 53 patients with median age of 57.49 years who had histological confirmed bladder cancer were recruited during this one year period. The male to female ratio was 1.3 to 1. Haematuria was a presenting complaint in over 94 % of patients and anemia was found in 82% of patients. Of the 53 patients, HIV infection was found in six patients (11.3 %). Squamous cell carcinoma was the most common histological type (60.4%) followed by Transitional cell carcinoma (30.2%) and adenocarcinoma was least common type (9.4%). Schistosoma infection was found in 14 patients all had SCC. The study found a statistically significant reduction in the mean age of bladder cancer in HIV infected patients.

Conclusions: Squamous cell carcinoma is still the most common histological type of bladder cancer in Zambia and it’s strongly associated with schistosomia infection. Haematuria remains to be the most common presenting symptom in bladder cancer patients.