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

Abstract

Background: Urinary bladder cancer is the ninth leading cause of morbidity and mortality globally, necessitating characterization of clinical and pathological features for early detection and improved management. Objective: To profile and document the clinicopathological features of urinary bladder cancer at Moi Teaching and Referral Hospital (MTRH). Materials and methods: A prospective assessment of patients diagnosed with urinary bladder cancer. Patient characteristics and associated causal factors obtained from full clinical evaluation and review of clinical records. Tumour characterization was based on examination and review of radiological imaging and histopathology findings and documented in structured questionnaires. Descriptive statistics and tests of association used Fisher’s exact tests for socio-demographic characteristics, causal factors, histological type, and Tumor, Node, Metastasis (TNM) stage of bladder cancer. Results: Forty-five patients aged between 21 to 85 (mean: 61.84 ± 14.46) years with urinary bladder cancer were evaluated. Males were 68.9% and painless hematuria was most common symptom. Exposure to agrochemicals (60%) and cigarettes smoking (mean pack years = 9.43 ±6.198) in 31%. Clinical staging showed 71.1% with T1, while 6.7% had metastatic disease. 55.6% had TNM stage I, while 91.1% had low-grade tumors. Transitional cell carcinoma (51.1%) was the most common histological type. Agrochemicals exposure was associated with low-grade tumors (p=0.013), TNM clinical stage I (p=0.021), and adenocarcinoma (p=0.029). Conclusions: Urinary bladder cancer affected males over 60 years old with a history of smoking and agrochemical exposure. Majority presented with classical symptoms of early disease and low-grade tumors. History of exposure to agrochemicals was a significant risk factor.