Prevalence and Clinicopathological Characteristics of Bladder Tumors in Bistrița-Năsăud County: A Retrospective Analysis (2018-2023) and the Impact of the COVID-19 Pandemic

Abstract

Objective: The primary aim of this study was to analyze the prevalence trends and the histopathological and demographic characteristics of bladder tumors diagnosed at the Pathology Department of the Bistrița-Năsăud County Emergency Clinical Hospital between 2018 and 2023. A secondary objective was to assess the impact of the COVID-19 pandemic on tumor diagnosis.

Methods: We conducted a retrospective cohort study including 279 cases diagnosed via bladder biopsy, transurethral resection of bladder tumor, and cystectomy. Variables such as age, sex, environment, intervention type, histopathological diagnosis, and TNM staging were collected. Statistical analysis was performed using Epi Info and Microsoft Excel, with a significance threshold set at p<0.05.

Results: Invasive urothelial tumors were the most common (n=144 cases, 51.61%), followed by non-invasive urothelial tumors (n=94, 34.05%), non-tumoral lesions (n=31, 11.11%), and non-urothelial tumors (n=9, 3.22%). Most cases occurred in men (n=226, 81%), particularly in the 61–70 and 71–80 age groups. Non-muscle invasive bladder cancers (pTa, T1) were triple as frequent as muscle-invasive bladder cancers. Comparing the pre-pandemic/pandemic (2018–2020) and post-pandemic (2021–2023) periods, we observed a 88% increase in total diagnosed cases (p<0.0001) along with a significant rise in both non-muscle invasive bladder cancers (+70%, p=0.002) and muscle invasive bladder cancers (+106%, p=0.017), the latter showing a more pronounced increase.

Conclusions: This study provides a comprehensive overview of the clinicopathological characteristics of bladder lesions within the Bistrița County area. Moreover, it highlights the notable impact of the COVID-19 pandemic on the diagnosis of new bladder cancer cases, including a shift toward more advanced tumor stages