Urinary Bladder Sriplung H
Incidence Risk factors As it is in other Asian popu- Tobacco smoking (Morrison Chapter II lations, Thailand is among the low et al., 1984; Hartge et al., 1987; incidence countries for bladder Pelucchi, et al., 2006) and certain cancer in comparison with western occupational exposures, in particu- countries. The estimated incidence lar to aromatic amines (IARC, rate of bladder cancer in Thailand 1982, 1987), have been implicated is 4.2 and 1.3 per 100 000 popula- as the major causes of bladder can- tion in males and females respec- cer. The factor(s) responsible for 18 tively. In males, the highest inci- the regional variations within Thai- dence of bladder cancer is observed land is/are not certain. The rela- in Rayong (ASR = 7.0) while in fe- tively elevated incidence in Chiang URINARY males, Rayong and Chiang Mai Mai, Lampang, and Rayong might have the highest incidence rate be related to the prevalence of BLADDER (ASR = 2.1; Figure 2.18.1). Since smoking as well as to the presence ICD-10 C67 it is an uncommon cancer among of certain occupational exposure females, the incidence rate is very such as local handicraft and chemi- low or not detectable in some prov- Hutcha Sriplung, M.D. cal related industries. Fruit and inces such as Nakhon Phanom and vegetable consumption was in- Prachuap Khiri Khan. Very low versely related with bladder cancer
below the age of 45 years, the age- IV Vol. in many studies (Pelucchi, et al., : specific incidence rates of bladder 2006). cancer rapidly rise with age (Figure 2.18.2).
Figure 2.18.1 Urinary bladder cancer in different regions, 1998-2000 CANCER IN THAILAND
1.3 Thailand 4.2 2.1 Chiang Mai 4.8 1.8 Lampang 4.5 0 Nakhon Phanom 2.3
Udon Thani 1.4 4.3 Female 0.6 Male Khon Kaen 4.1 1.8 Bangkok 5.9 2.1 Rayong 7 0.3 Prachuap Khiri Khan 2.1 0.8 Songkhla 4.5
012345678 ASR (World) 61
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Figure 2.18.2 Age-specific incidence rates of urinary bladder cancer, 1998-2000
Male Female
90 90
80 80
70 70
60 60
THAILAND 50 50 CHIANG MAI LAMPANG NAKHON PHANOM 40 40 UDON THANI KHON KAEN
30 30
Incidence per 100 000
20 20
10 10
0 0 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ Age
90 90
80 80
70 70
Vol. IV Vol. : 60 60
THAILAND 50 50 BANGKOK RAYONG PRACHUAP KHIRI KHAN 40 40 SONGKHLA
Incidence per 100 000 30 30
20 20
10 10
0 0 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ 0- 5- 10- 15- 20- 25- 30- 35- 40- 45- 50- 55- 60- 65- 70- 75+ Age
CANCER IN THAILAND
62
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