Caractéristiques épidémiologiques du cancer de la vessie chez la femme en Tunisie

Abstract

IntroductionThe incidence of urinary bladder cancer is constantly increasing with a three-fold increased preponderance in men. The fact that women are less prone to bladder cancer and the factors behind this are the topic of this study. Patients and methodsThis retrospective study included 64 women seen at the urology department of Charles Nicolle Hospital, Tunis, Tunisia, between January 2003 and December 2009. The incidence of bladder cancer in these patients was analyzed based on the following data: number of cases per year, patients’ age, patients’ geographical and social background and risk factors. ResultsThe distribution of patients with bladder cancer was homogeneous with an average of 9.14 cases per year. Also from the geographical point of view, the patients were equally distributed between urban and rural areas. The patients’ mean age was 67.9 years. We found a history of recurrent cystitis in 3 patients, while 2 had a previous history of cancer of the upper urinary tract. 29.6% of the patients had a history of smoking. Only 5.4% of the patients were exposed to industry-related urothelial carcinogens. DiscussionThe incidence of female bladder cancer in Tunisia is one of the lowest worldwide. It increases with age. Smoking is the most important risk factor followed by exposure to urothelial carcinogens. The changes that have occurred in women's social and professional life have led to an increased exposure to industry-related carcinogens. This partly explains the increased incidence of bladder cancer which, however, is not as significant as the increase in lung cancer. Some factors such as estrogens and dietary factors may protect women from bladder cancer, but this assumption needs to be scientifically proved. ConclusionThis is the first study on urinary bladder tumors in women carried out in Tunisia. It has shown that the incidence of this type of cancer is constantly, but moderately increasing. This fact may partly be explained by the women's new way of life, especially professional life, which for some women leads to a higher exposure to carcinogens.