Carcinoma Of The Urinary Bladder In Maiduguri: The Schistosomiasis Connection

Abstract

Results: All but 13 of the 65 confirmed cases were males, giving a male to female ratio of 4 to 1. Squamous cell carcinoma (SCC) of the bladder (n=46) was significantly commoner than transitional cell carcinoma (TCC) cases (n=15), in those with past history of Schistosomiasis (p< 0.001), with a Relative Risk (RR) of 4.06. Also 65.2% of SCC showed Schistosomiasis in the histology specimen compared with 13.3% of TCC cases (P < 0.001) Four patients had undifferentiated carcinoma, 3 (75%) of which showed Schistosoma ova in their specimen. Patients with SCC were significantly younger (45.26 +/- SD13.5years) than those with TCC (P< 0.001). Our patients were mostly farmers of low socio-economic class. Most presented with advanced disease, thus treatment was mostly palliative and the outcome quite poor. Conclusion: This result clearly shows that carcinoma of the bladder in Maiduguri, North East of Nigeria, is mainly SCC and strongly associated with Schistosomiasis. Therefore, a deliberate policy and effort to control Schistosomiasis in this region will lead to a reduction in the incidence of bladder cancer and the attendant morbidity and mortality.