Bladder cancer (BC) is a common cancer worldwide with an estimated 429, 793 new cases and 165, 084 deaths in 2012. Its projected age-standardized incidence rate among the world population (ASR(w)) per 100 000 person-years was reported to be 5.3 in 2012 with higher rates among males (9.0 in 2012) as compared to females (2.2 in 2012). Excluding nonmelanoma skin cancer, BC was the ninth most common cancer in both sexes, the sixth cancer in males, and the nineteenth in females worldwide in 2012. The incidence of BC is reported to be higher in industrialized developed areas such as in Europe and North America.
Most BCs are associated with acquired risk factors such as tobacco smoke, followed by occupational exposure to chemical carcinogens such as polycyclic aromatic hydrocarbons, nitrosamines, arsenic, and particularly aromatic amines. Other risk factors include urinary schistosomiasis, certain chemotherapeutic agents such as cyclophosphamide, pelvic radiation therapy, environmental pollution, and some dietary and lifestyle factors. Inherited genetic predispositions have also been reported to influence the risk of BC, especially with an added risk effect by other factors, mainly tobacco smoke. Primary prevention, through avoiding exposure to risk factors, is important to reduce disease-specific morbidity and mortality. Screening for BC in high-risk populations is debatable, and the current evidence is insufficient to assess the balance of benefits and harms of screening for BC in asymptomatic adults.
Lebanon is a small developing Middle Eastern country with an estimated population of around 5 million in 2013. Lebanon has health indices that are close to those of more developed countries, with a reported infant mortality rate of 8 per 1000 live births in 2012 and maternal mortality ratio of 15 per 100 000 live births in 2015. Despite not being an industrialized country, Lebanon has one of the highest estimated ASR(w) of BC worldwide, with 29.1 as estimated ASR(w) of BC among males, thus falling second after Belgium (31.0). After several years of being inactive during war years, the Lebanese National Cancer Registry (NCR) was officially restarted in 2002 and is believed to be an almost absolute count of all incident cases in Lebanon with data collected passively from physicians’ reports (capture system) and actively from histopathological and hematological laboratories (recapture system). The recapture system is used to validate and complement data obtained through passive reporting. However, this registry does not include data on noninvasive precancerous lesions and in situ lesions. The NCR has published its cancer incidence data on the official web site of the Ministry of Public Health; the available revised ones cover the period between 2005 and 2011.
The aim of this study is to analyze the 7-year incidence rates for BC in Lebanon and to compare these rates to the ones in the Middle East and North Africa (MENA) region, as well as Western and Eastern countries. This study will also review and discuss different possible BC risk factors in Lebanon.