Decreasing incidence of urothelial cancer in a Balkan endemic nephropathy region in Serbia. A surgery based study from 1969 to 1998.

The incidence of upper urothelial tumors (UUT) and bladder tumors associated to Balkan endemic nephropathy (BEN) in the region of South Morava River in Serbia, in the 30-year period, was studied. A total of 575 urothelial neoplasms during 10-year period (1989-1998) was analyzed and compared to 659 urothelial neoplasms in the period from 1969 to 1988. UUT had 11.2-fold increased incidence in endemic than in nonendemic areas, however, this was far less than in the period from 1969 to 1988, when they were 57.1 times more frequent. Bladder tumors were 2.3 times more frequent in endemic than in nonendemic areas, but 11.9 times in the previous study from 1969 to 1988. Neoplasms from the area of BEN, regardless of their location, were not histologically different from the neoplasms out of endemic areas. Similarly to the previous reports that BEN looks like a disease that disappears, this is demonstrated also for urothelial tumors, which are the most frequent associated diseases.