Objectives: To compare the epidemiological and histological characteristics of upper urinary tract tumours in the region of Balkan endemic nephropathy with those of urothelial tumours observed in other regions.
Material and methods: From 1970 to 1997, 766 patients were treated in the Belgrade Department of Urology for an upper urinary tract tumour. These patients were derived from 3 regions: the region of Balkan endemic nephropathy (BEN), the region of probable Balkan endemic nephropathy (PBEN) and the region without Balkan endemic nephropathy (WBEN). The incidence of tumours in BEN + PBEN patients was 68% versus 32% for WBEN patients. The histological and epidemiological characteristics of the tumours in these three groups were compared.
Results: Tumours were more frequent in women in the BEN and PBEN groups (1.2:1 and 1.1:1) than in the WBEN group (0.6:1). The tumour was diagnosed an average of 5 years later in the first 2 groups than in the WBEN group (p < 0.05). The BEN and PBEN groups presented a higher incidence of renal failure (45% and 35%), but especially a much higher incidence of bilateral tumours (13% and 6%) than in the WBEN region (2%).
Conclusion: Our analysis shows that upper urinary tract tumours depend on geographical factors: the incidence of these tumours is significantly higher in regions of BEN and PBEN, women are more frequently affected, tumours are associated with a high incidence of renal failure, bilateral tumours are more frequent, and tumours are more frequent in older patients. Comparison of the histological and pathological characteristics of the tumours did not reveal any significant difference between these three regions.