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African Journal of Urology

, Volume 15, Issue 2, pp 84–87 | Cite as

The pattern of urological cancers in Zambia

  • K. BowaEmail author
  • J. S. Kachimba
  • M. A. Labib
  • V. Mudenda
  • M. Chikwenya
Original Article

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.

Keywords

urological cancers Zambia 

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References

  1. 1.
    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.Google Scholar
  2. 2.
    Elem B, Patil PS. Pattern of urological malignancy in Zambia. A hospital-based histopathological study. Br.J.Urol. 1991; Jan;67(1):37–39.PubMedCrossRefGoogle Scholar
  3. 3.
    Office of National Statistics. Mortality statistics — causes England and Wales. 1999.Google Scholar
  4. 4.
    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.PubMedGoogle Scholar
  5. 5.
    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.PubMedGoogle Scholar
  6. 6.
    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.Google Scholar
  7. 7.
    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.Google Scholar
  8. 8.
    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.CrossRefGoogle Scholar
  9. 9.
    Heyns CF, van der Merwe A. Bladder cancer in Africa. Can.J.Urol. 2008; Feb;15(1):3899–3908.PubMedGoogle Scholar
  10. 10.
    El Mawla NG, el Bolkainy MN, Khaled HM. Bladder cancer in Africa: Update. Semin.Oncol. 2001; Apr;28(2):174–178.PubMedCrossRefGoogle Scholar
  11. 11.
    Shokeir AA. Squamous cell carcinoma of the bladder: Pathology, diagnosis and treatment. BJU Int. 2004; Jan;93(2):216–220.PubMedCrossRefGoogle Scholar
  12. 12.
    Aucamp JW, Heyns CF. Surgical complications of radical cystectomy in a teaching hospital. S.Afr.J.Surg. 1995; Mar;33(1):31–38.PubMedGoogle Scholar
  13. 13.
    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.PubMedGoogle Scholar
  14. 14.
    MacVicar AD. Bladder cancer staging. BJU Int. 2000; Jul;86Suppl 1:111–122.PubMedGoogle Scholar
  15. 15.
    Pashos CL, Botteman MF, Laskin BL, Redaelli A. Bladder cancer: epidemiology, diagnosis and management. Cancer Pract. 2002; Nov–Dec;10(6):311–322.PubMedCrossRefGoogle Scholar
  16. 16.
    Bhagwandeen SB. Schistosomiasis and carcinoma of the bladder in Zambia. S.Afr.Med.J. 1976; Sep 25;50(41):1616–1620.PubMedGoogle Scholar
  17. 17.
    Mungomba LM, Michelson EH. Urban schistosomiasis in Lusaka, Zambia: A preliminary study. J.Trop.Med. Hyg. 1995; Jun;98(3):199–203.PubMedGoogle Scholar
  18. 18.
    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):279–283PubMedCrossRefGoogle Scholar

Copyright information

© PAUSA and Springer Verlag France 2009

Authors and Affiliations

  • K. Bowa
    • 1
    Email author
  • J. S. Kachimba
    • 1
  • M. A. Labib
    • 1
  • V. Mudenda
    • 2
  • M. Chikwenya
    • 3
  1. 1.Department of UrologyUniversity of Zambia Teaching HospitalLusakaZambia
  2. 2.Department of PathologyUniversity of Zambia Teaching HospitalLusakaZambia
  3. 3.University of Zambia HPB projectLusakaZambia

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