Bladder cancer in southwestern Iran: Histopathologic and clinical features

Background: Bladder cancer (BC) is one of the leading causes of cancer death. However, there is little knowledge on the histopathologic features of BC in Iran. In line with our previous report, the aim of this study was to investigate the epidemiologic, histopathologic and clinical features of BC in southwestern Iran 2009-2015. Methods: Data were retrieved from Nemazee and Faghihi cancer registries. Data were cleaned and prepared to statistical analysis. Data were described using descriptive statistics and more explored to test some of our hypotheses. Univariate and multivariate logistic regression were done. Results: A total of 756 patients with a mean age of 64.51±12.99 years were enrolled. Male: female ratio was a 3.97 and consistent across age groups. Among both genders, initial presentation of 79% of patients was painless hematuria. 94.7% of tumors were transitional cell carcinoma, 43.1% were muscle invasive, 26.2% were metastatic and 50.7% were high grade tumors. 86% of none-muscle- invasive and 44.0% of invasive tumors were managed by transurethral resection of bladder. Recurrence was seen in 436 (57.7%) of patients and was associated with hookah tobacco smoking (Adjusted Odds ratio: 1.44, 95% CI: 1.01- 2.1) and history of hypertension (1.36, 1.00-1.86). Conclusions: Delayed diagnosis, younger ages at diagnosis and a similar share of advanced tumors between males and females were remarkable differences of epidemiologic features of BC in southwestern Iran compared with western countries. While management of non- muscle invasive tumors meet the recommended standards of care but it does not for muscle invasive tumors.