Introduction: The incidence of bladder cancer in women has steadily increased in recent years. The objective of our work is to study the epidemiological profile of bladder cancer in women in our population and the factors favoring its occurrence. Methods: This is a retrospective study carried out at the Mohamed Center VI for cancer treatment, involving 27 women during a two-year period from January 2019 to December 2020. We studied the epidemiological characteristics in these patients, the risk factors and the revealing symptoms. Results: The average age of patients was 67.5 years old and 66.66% of the patients were over 65 years old. One patient had in her antecedents a tumor of the upper excretory tract and 2 patients had an associated renal tumor. The notion of smoking was found in 3 patients. The time to treatment was less than 6 months in 44.4% of cases, between 6 and 12 months in 18.5% of cases, and more than a year in 37% of cases. The symptoms were marked by hematuria in 96.3% of cases, and irritative disorders in 81.4% of cases. In our series; the tumor was unifocal in 77.77% of the cases, and multifocal in the remainder of the cases. Urethrohydronephrosis was found in 74% of cases. Histologically, it was an urothelial carcinoma in 81.48% of cases. The tumor was locally advanced in 11.11% of cases, and metastatic in 11.11% of cases. Lymph node involvement was found in 33.33% of cases. 48.1% of cases underwent surgery. The operative procedure consisted of a partial cystectomy in 46.1% of cases, and only 18.5% was suitable for trimodal treatment. Conclusion: Few studies have addressed the epidemiology of bladder cancer in women due to the low incidence, but it is currently increasing steadily in recent years. These modifications are explained by the change in social habits in women.
References
[1]
Mishriki, S.F., Vint, R. and Somani, B.K. (2012) Half of Visible and Half of Recurrent Visible Hematuria Cases Have Underlying Pathology: Prospective Large Cohort Study with Long-Term Follow-Up. The Journal of Urology, 187, 1561-1565.
https://doi.org/10.1016/j.juro.2011.12.100
[2]
Pelucchi, C., La Vecchia, C., Negri, E., Dal Maso, L. and Franceschi, S. (2002) Smoking and Other Risk Factors for Bladder Cancer in Women. Preventive Medicine, 35, 114-120. https://doi.org/10.1006/pmed.2002.1061
[3]
Kirkali, Z., Chan, T., Manoharan, M., et al. (2005) Bladder Cancer: Epidemiology, Staging and Grading, and Diagnosis. Urology, 66, 4-34.
https://doi.org/10.1016/j.urology.2005.07.062
[4]
Silverman, D.T., Devesa, S.S., Moore, L.E., et al. (2006) Bladder Cancer. In: Schot-Tenfeld, D. and Fraumeni, J., Eds., Cancer Epidemiology and Prevention, Oxford University Press, New York, 1101-1127.
https://doi.org/10.1093/acprof:oso/9780195149616.003.0058
[5]
Boorman, G.A. (1999) Drinking Water Disinfection Byproducts: Review and Approach to Toxicity Evaluation. Environmental Health Perspectives, 107, 207-217.
https://doi.org/10.1289/ehp.99107s1207
[6]
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (1987) Overall Evaluations of Carcinogenicity: An Updating of IARC Monographs Volumes 1 to 42. International Agency for Research on Cancer, Lyon.
[7]
Pop, W., Schmieding, W., Speck, M., Vahrenholz, C. and Norpoth, K. (1992) Incidence of Bladder Cancer in a Cohort of Workers Exposed to 4-Chloro-o-Toluidine While Synthesizing Chlordimeform. British Journal of Industrial Medicine, 49, 529-531. https://doi.org/10.1136/oem.49.8.529
[8]
Boffetta, P., Jourenkova, N. and Gustavsson, P. (1997) Cancer Risk from Occupational and Environmental Exposure to Polycyclic Aromatic Hydrocarbons. Cancer Causes & Control, 8, 444-472. https://doi.org/10.1023/A:1018465507029
[9]
McGrath, M., Michaud, D.S. and De Vivo, I. (2006) Hormonal and Reproductive Factors and the Risk of Bladder Cancer in Women. American Journal of Epidemiology, 163, 236-244. https://doi.org/10.1093/aje/kwj028
[10]
Prizment, A.E., Anderson, K.E., Harlow, B.L. and Folsom, A.R. (2007) Reproductive Risk Factors for Incident Bladder Cancer: Iowa Women’s Health Study. International Journal of Cancer, 120, 1093-1098. https://doi.org/10.1002/ijc.22418
[11]
Pillalamarri, N., Shalom, D., Sanidad, S., Akerman, M., Lind, L. and Winkler, H. (2015) The Prevalence of Microscopic Hematuria in a Cohort of Women with Pelvic Organ Prolapse. International Urogynecology Journal, 26, 85-90.
https://doi.org/10.1007/s00192-014-2450-6
[12]
Birnbaum, L.S. (1987) Age-Related Changes in Carcinogen Metabolism. Journal of the American Geriatrics Society, 35, 51-60.
https://doi.org/10.1111/j.1532-5415.1987.tb01319.x
[13]
Bhatt, N.R., Davis, N.F., Nolan, W.J., Flynn, R.J., McDermott, T., Thomas, A.Z. and Manecksha, R.P. (2018) Incidence of Visible Hematuria among Antithrombotic Agents: A Systematic Review of over 175,000 Patients. Urology, 114, 27-32.
https://doi.org/10.1016/j.urology.2017.11.023
[14]
Tandogdu, Z. and Wagenlehner, F.M. (2016) Global Epidemiology of Urinary Tract Infections. Current Opinion in Infectious Diseases, 29, 73-79.
https://doi.org/10.1097/QCO.0000000000000228
[15]
Nielsen, M. and Qaseem, A. (2016) Hematuria as a Marker of Occult Urinary Tract Cancer: Advice for High-Value Care from the American College of Physicians. Annals of Internal Medicine, 164, 488-497. https://doi.org/10.7326/M15-1496
[16]
Rouprêt, M., Neuzillet, Y., Pignot, G., Compérat, E., Audenet, F., Houédé, N., et al. (2018) French ccAFU Guidelines—Update 2018-2020: Bladder Tumors. Progrès en Urologie, 28, S46-S78. https://doi.org/10.1016/j.purol.2018.07.283
[17]
Froehner, M., Brausi, M.A., Herr, H.W., Muto, G. and Studer, U.E. (2009) Complications Following Radical Cystectomy for Bladder Cancer in the Elderly. European Urology, 56, 443-454. https://doi.org/10.1016/j.eururo.2009.05.008
[18]
Aziz, A., et al. (2014) Prediction of 90-Day Mortality after Radical Cystectomy for Bladder Cancer in a Prospective European Multicenter Cohort. European Urology, 66, 156-163. https://doi.org/10.1016/j.eururo.2013.12.018
[19]
Ziouziou, I., et al. (2018) Ileal Conduit vs Orthotopic Neobladder: Which One Offers the Best Health-Related Quality of Life in Patients Undergoing Radical Cystectomy? A Systematic Review of Literature and Meta-Analysis. Progrès en Urologie, 28, 241-250. https://doi.org/10.1016/j.purol.2018.02.001
[20]
Tester, W., Porter, A., Asbell, S., Coughlin, C., Heaney, J., Krall, J., et al. (1993) Combined Modality Program with Possible Organ Preservation for Invasive Bladder Carcinoma: Results of RTOG Protocol 85-12. International Journal of Radiation Oncology, Biology, Physics, 25, 783-790.
https://doi.org/10.1016/0360-3016(93)90306-G
[21]
Rotman, M., Aziz, H., Porrazzo, M., Choi, K.N., Silverstein, M., Rosenthal, J., et al. (1990) Treatment of Advanced Transitional Cell Carcinoma of the Bladder with Irradiation and Concomitant 5-Fluorouracil Infusion. International Journal of Radiation Oncology, Biology, Physics, 18, 1131-1137.
https://doi.org/10.1016/0360-3016(90)90449-T
[22]
Rödel, C., Grabenbauer, G.G., Kühn, R., Papadopoulos, T., Dunst, J., Meyer, M., et al. (2002) Combined-Modality Treatment and Selective Organ Preservation in Invasive Bladder Cancer: Long-Term Results. Journal of Clinical Oncology, 20, 3061-3071.
https://doi.org/10.1200/JCO.2002.11.027
[23]
Mak, R.H., Hunt, D., Shipley, W.U., Efstathiou, J.A., Tester, W.J., Hagan, M.P., et al. (2014) Long-Term Outcomes in Patients with Muscle-Invasive Bladder Cancer after Selective Bladder-Preserving Combined-Modality Therapy: A Pooled Analysis of Radiation Therapy Oncology Group Protocols 8802, 8903, 9506, 9706, 9906, and 0233. Journal of Clinical Oncology, 32, 3801-3809.
https://doi.org/10.1200/JCO.2014.57.5548
[24]
Nagao, K., Hara, T., Nishijima, J., Shimizu, K., Fujii, N., Kobayashi, K., et al. (2017) The Efficacy of Trimodal Chemoradiotherapy with Cisplatin as a Bladder-Preserving Strategy for the Treatment of Muscle-Invasive Bladder Cancer. Urologia Internationalis, 99, 446-452. https://doi.org/10.1159/000477912
[25]
Arcangeli, G., Strigari, L. and Arcangeli, S. (2015) Radical Cystectomy versus Organ-Sparing Trimodality Treatment in Muscle-Invasive Bladder Cancer: A Systematic Review of Clinical trials. Critical Reviews in Oncology/Hematology, 95, 387-396.
https://doi.org/10.1016/j.critrevonc.2015.04.006
[26]
Fahmy, O., Khairul-Asri, M.G., Schubert, T., Renninger, M., Malek, R., Kübler, H., et al. (2018) A Systematic Review and Meta-Analysis on the Oncological Long-Term Outcomes after Trimodality Therapy and Radical Cystectomy with or without neoadjvant Chemotherapy for Muscle Invasive Bladder Cancer. Urologic Oncology: Seminars and Original Investigations, 36, 43-53.
https://doi.org/10.1016/j.urolonc.2017.10.002
