- Original Article
- Published:
The pattern of urological cancers in Zambia
African Journal of Urology volume 15, pages 84–87 (2009)
Abstract
Objective
To examine the pattern of urological malignancies, particularly cancer of the bladder, seen at the University Teaching Hospital (UTH) in Lusaka and to compare the findings with previous studies on the same parameters done at UTH.
Material and Methods
A retrospective study of urological cancers in Zambia was performed, based on histopathology reports of specimens reviewed at the UTH Pathology Laboratory in Lusaka, Zambia, between January 1990 and December 2005. The parameters studied were the histological type of the cancer, patient age and trends over a 15-year period.
Results
In total, 8829 cancers were diagnosed during the study period, of which 749 (8.5%) were urological malignancies affecting the kidney, bladder, prostate, testis or penis. The male-to-female ratio of the urological cancers was 10.7 to 1. Cancer of the prostate was the most common urological malignancy (54.6%), followed by bladder cancer (21.1%) and penile cancer (18.6%). The histological type of bladder cancer was mainly squamous cell carcinoma (46.2%), transitional cell carcinoma (23.4%) and adenocarcinoma (22.2%); other types (8.2%) included rhabdomyosarcoma, small cell carcinoma and lymphoma. The majority of patients (79%) with bladder cancer were between 56 and 65 years of age. Whereas 20 years ago prostate cancer comprised only 26% of urological malignancies, it accounted for 55% of urological cancers diagnosed in Zambia between 1990 and 2005. In contrast, cancer of the penis, kidney and testis have shown no change in frequency distribution compared to 20 years ago.
Conclusion
Over the last 15 years there has been an increasing proportion of cancer of the prostate and squamous cell carcinoma of the bladder. This is associated with high levels of schistosomiasis, cystitis (some of which is HIV-related) and bladder stones. It may also be due to the extension of urological services and the diagnostic armamentarium (PSA, cystoscopy and histological diagnosis) to indigent rural populations, where the incidence of squamous cell carcinoma is likely to be higher than in affluent urban populations.
References
Parkin DM, Ferley J, Hamdi Cherif M, Sitas F, Thomas J, Wabinga H, et al. International Agency for Research on Cancer World Health Organisation. Cancer in Africa: Epidemiology and prevention. Lyon, France: IARC Press; 2000.
Elem B, Patil PS. Pattern of urological malignancy in Zambia. A hospital-based histopathological study. Br.J.Urol. 1991; Jan;67(1):37–39.
Office of National Statistics. Mortality statistics — causes England and Wales. 1999.
Klufio GO. A review of genitourinary cancers at the Korle-Bu teaching hospital Accra, Ghana. West Afr.J.Med. 2004; Apr-Jun;23(2):131–134.
Patil P, Elem B, Zumla A. Pattern of adult malignancies in Zambia (1980–1989) in light of the human immunodeficiency virus type 1 epidemic. J.Trop.Med. Hyg. 1995; Aug;98(4):281–284.
Watts T. Zambia: The cancer registry of Zambia, Lusaka, November 1981–May 1983. In: Parkin DM, ed. Cancer occurrence in developing countries (IARC Scientific Publications No. 75) Lyon, IARC, 1988; pp 117–121.
O’Riordan EC. Department of Pathology, Ndola Central Hospital 1976–1979. In: Parkin DM, ed. Cancer occurrence in developing countries (IARC Scientific Publications No 75), Lyon, IARC, 1988; pp 122–123.
Bowa K, Labib M. UP-02.102: Lower tract urinary calculi as an index of urological services in a developing country. Urol. 2006; Nov;68(Suppl 1):283.
Heyns CF, van der Merwe A. Bladder cancer in Africa. Can.J.Urol. 2008; Feb;15(1):3899–3908.
El Mawla NG, el Bolkainy MN, Khaled HM. Bladder cancer in Africa: Update. Semin.Oncol. 2001; Apr;28(2):174–178.
Shokeir AA. Squamous cell carcinoma of the bladder: Pathology, diagnosis and treatment. BJU Int. 2004; Jan;93(2):216–220.
Aucamp JW, Heyns CF. Surgical complications of radical cystectomy in a teaching hospital. S.Afr.J.Surg. 1995; Mar;33(1):31–38.
Groeneveld AE, Marszalek WW, Heyns CF. Bladder cancer in various population groups in the greater Durban area of KwaZulu-Natal, South Africa. Br.J.Urol. 1996; Aug;78(2):205–208.
MacVicar AD. Bladder cancer staging. BJU Int. 2000; Jul;86Suppl 1:111–122.
Pashos CL, Botteman MF, Laskin BL, Redaelli A. Bladder cancer: epidemiology, diagnosis and management. Cancer Pract. 2002; Nov–Dec;10(6):311–322.
Bhagwandeen SB. Schistosomiasis and carcinoma of the bladder in Zambia. S.Afr.Med.J. 1976; Sep 25;50(41):1616–1620.
Mungomba LM, Michelson EH. Urban schistosomiasis in Lusaka, Zambia: A preliminary study. J.Trop.Med. Hyg. 1995; Jun;98(3):199–203.
Mungomba LM, Chandiwana SK, Sukwa TY, Marshall I. Effect of human immigration on the age distribution of schistosome infections in Siavonga community, Lake Kariba, Zambia. Ann.Trop.Med.Parasitol. 1998; Apr;92(3):279–283
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bowa, K., Kachimba, J.S., Labib, M.A. et al. The pattern of urological cancers in Zambia. Afr J Urol 15, 84–87 (2009). https://doi.org/10.1007/s12301-009-0025-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12301-009-0025-4