A Clinicopathological Correlation of Bladder Cancer in Young and Old Patients: Our Experience and Review of Literature.

Abstract

To compare the clinical, cystoscopic, and pathological characteristics of bladder cancer in patients younger than 40years of age and those of patients older than 40years of age. We conducted a prospective observational study at our department from September 2019 to February 2021 to compare the clinico-pathological characteristics of young and old patients with biopsy proven bladder cancer after a transurethral resection of bladder tumour. The patients were managed according to standard guidelines. Two hundred sixty-eight patients of bladder cancer were included in the analysis. Out of these, 58 patients were < 40years of age and 210 were > 40years. The mean age of two groups were 31.43 ± 6.30 vs 59.08 ± 9.87years. With respect to tumour grade, 36.2% (versus 17.6%) of young patients had low grade tumour, and 58.6% had high-grade tumour (versus 82.4%). In the young population, 63.8% patients had NMIBC (versus 61.9%) and 36.2% had MIBC (versus 38.1%). Even in the NMIBC group, a large majority of young patients had high-risk disease (51.4%). The incidence of bladder cancer is on the rise in the northern belt of India, especially in the younger age group. High exposure to smoke and heavy metals in drinking water/occupation are the major risk factors. Majority of young patients aged < 40years had a high-grade disease on presentation and a large subset had muscle invasive bladder cancer, contrary to previously reported studies.