FACTORS RESPONSIBLE FOR DELAYED PRESENTATION & MANAGEMENT OF SYMPTOMATIC BLADDER CANCER IN PAKISTAN: A SINGLE CENTRE STUDY

  • DR. AZFAR ALI Postgraduate Medical Institute, Ameer ud Din Medical College, Lahore General Hospital, Lahore
  • DR. NABEEL SHAFI SIMS/ Services Hospital, Lahore
  • DR. ASAD ALI SHAH SIMS/ Services Hospital, Lahore
  • DR. BASIT MASOOD Alshifa International Hospital, Islamabad
  • DR. MOHAMMAD HASSAM KHALID Allied Hospital / PMC, Faisalabad
  • DR. IRSHAD ALI SIMS/Services Hospital Lahore
  • DR. MUHAMMAD SAFDAR KHAN King Edward Medical University Lahore
Keywords: Bladder Cancer, Diagnosis, Haematuria, Mortality

Abstract

Background: Carcinoma of bladder is a urological cancer which has the highest recurrence rate of any malignancy in Asia and America. In Pakistan bladder carcinoma is one of most common occurring cancer in men and number one urological malignancy in both sexes. Haematuria is the most common presentation of bladder cancer. Delay in treatment for bladder cancer resulted in in poor survival outcomes. Rationale of this study is to investigate the factors responsible for late presentation of symptomatic bladder cancer to a urologist, despite of alarming signs and symptoms. Materials and Methods: From 20-02-15 to 21-02-2017, A total number of 112 patients, 84 males, 28 females who presented first time for the treatment of bladder cancer and history of visible haematuria were enrolled and data was collected by researchers in Department of urology Services Hospital Lahore. Patient with recurrent bladder cancer and with history of XRT bladder were excluded. A proforma was filled which included personal details as age, education, social status, history of smoking, presenting complains, psycho-social barriers, time delay from symptom to definite treatment

Results: Out of 112 patients, 60(53.6%) were illiterate, 76(67.9%) belonged to rural areas, 79(70.5 %) belonged to low socio-economic status. 91(81%) males were smokers. 92.9% patients had history of multiple episodes of haeamturia. Median delay from first episode of haematuria to treatment (TURBT) was 118 (IQR 70-207)days, The main factors were for this patient delay were lack of awareness/ knowledge about disease in 68(60.7%).Delay due to General practitioner was 65.42±35 days in 76(67.8%) patients, while hospital delay was 13.3±7.27 days

Conclusion: Public education about bladder cancer with training of general physicians for early referral can prevent delayed presentation, resulting in prevention of disease's progression and mortality.

Author Biographies

DR. AZFAR ALI, Postgraduate Medical Institute, Ameer ud Din Medical College, Lahore General Hospital, Lahore

Assistant Professor Of Urology

DR. NABEEL SHAFI, SIMS/ Services Hospital, Lahore

Senior Registrar of Urology

DR. ASAD ALI SHAH, SIMS/ Services Hospital, Lahore

Assistant Professor Of Urology

DR. BASIT MASOOD, Alshifa International Hospital, Islamabad

Post Graduate Resident Urology

DR. IRSHAD ALI, SIMS/Services Hospital Lahore

Registrar of Urology

DR. MUHAMMAD SAFDAR KHAN, King Edward Medical University Lahore

Professor Of Urology

Published
2015-06-01