Bladder Cancer Burden and Challenges of Management in Kano, North Western Nigeria

Author(s): Bashir Yunusa, Muzzammil Abdullahi, Sharfuddeen Abbas Mashi, Sani Ali Aji, Auwal Sani, Sani Abdullahi Giade, Sani Alhassan Usman

Introduction: Bladder cancer is the ninth most common cancer worldwide and second most common urologic cancer after prostate cancer. Worldwide, about ninety percent of bladder cancers are transitional cell cancers (TCC); others are squamous cell carcinoma (SCC) which comprises approximately 6-8%, and adenocarcinoma about 2%. However, in schistosomiasis endemic areas, SCC constitutes as high as 44-82% of bladder cancer. Schistosomiasis caused by S. hematobium is endemic in Africa, southern tips of Europe and parts of Japan.

Objectives: We aim to review the burden, pathology and clinical management of bladder cancers in Kano, North-Western Nigeria.

Methods: We retrospectively reviewed the records of all (98) patients seen and diagnosed to have bladder cancer and offered some form of intervention at Aminu Kano Teaching Hospital, Kano, from January 2011 to June 2016. Information obtained were risk factors, mode of presentation, histological type and intervention given and analysed by SPSS Version 16 and presented in tables and charts.

Results: There were a total of 98 patients seen with clinical diagnosis of bladder cancer. The mean age (±SD) was 51.4 +13.9 years, with male to female ratio of 10:1. Ninety one (91%) presented as an emergency, 37 (84%) had identifiable risk factors. More than half of the patients (52%) couldn’t have a representative tissue for histology because of advanced disease with necrotic tissues at presentation. About 44% has SCC while 29% was TCC.

Conclusion: Squamous cell carcinoma is still the predominant histological subtype of bladder cancer in our environment owing to endemicity of schistosomiasis and usually present in advanced stage.



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