Pattern of transitional cell carcinoma of the urinary bladder as seen at Kenyatta National Hospital, Nairobi

Objective: To highlight the pattern of patients with transitional cell carcinoma of the urinary bladder with regards to age, sex, ethnic origin and histopathological classification. Design: A ten year retrospective study. Setting: Kenyatta National Hospital, Nairobi, Kenya. Subjects: Fifty two patients who presented at Kenyatta National Hospital over the ten year period with histologically proven transitional cell carcinoma of the urinary bladder. There were 41 males and 11 females aged 27 to 84 years. The mean age was 57 years. Results: The peak incidence was in the 60-69 years age group. The male to female ratio was 4:1. The regional (provincial) distribution revealed Central and Eastern had 77%, Rift valley had 6%, Nairobi, North Eastern, Western and Coast provinces had 2% each. In the ethnic distribution; Kikuyus, Kambas and Merus were 77% while others were 17.3%. Transitional cell carcinoma was found in 67% of the patients, 60% had advanced disease. Twenty nine percent were smokers while 25% consumed alcohol. The main occupation was farming in 65%. The most Common clinical presentations were haematuria 98% and lower abdominal pains in 71%. A total of 99,028 patients were admitted to the surgical wards,transitional cell carcinoma patients represented only 0.6%. Conclusion: Transitional cell carcinoma is a rare disease. At Kenyatta National Hospital it only represented 0.6% of all surgical admissions during the study period. It accounted for 67% of all bladder tumours an increase in incidence compared to previous studies. It is common in males more than females, with a peak in the seventh decade. Majority of the patients were from central Kenya. Alcohol, smoking and farming were the most important risk factors. Haematuria was the most important presenting clinical feature. Poor record keeping may have contributed to the low number of patients enrolled into the study. There is need for a thorough prospective study to find out the actual prevalence of bladder tumours. East African Medical Journal Vol. 81 No. 3 March 2004: 114-11