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Erschienen in: Wiener klinische Wochenschrift 17-18/2013

01.09.2013 | original article

Upper urothelium carcinomas in Croatian endemic area

verfasst von: Ante Cvitković, PhD, MD, Igor Ivić-Hofman, MD, Dragana Jurić

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 17-18/2013

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Summary

Background/Aims

Endemic nephropathy (EN) is a chronic tubulointerstitial disease. Strong association between EN and urothelial carcinoma was noted as early as 40–50 ago. The aim of the study was to determine and compare specific mortality and morbidity of renal pelvis and ureter (upper urothelium) carcinoma (UUC) among Croatia as a whole, Brod-Posavina County, and Croatian endemic area.

Methods

Data on UUC mortality and morbidity were analyzed. Indirect standardization was employed on data comparison by calculating standardized mortality ratio and morbidity ratio.

Results

Our study results showed the specific mortality rate in the endemic area to be 26.3-fold and 7.3-fold the rate recorded in Croatia and Brod-Posavina County, respectively. The mean standardized mortality ratio obtained by indirect standardization yielded an 8-fold and 32-fold risk of death from UUC in the endemic area vs. Brod-Posavina County and Croatia as a whole, respectively. These data revealed the specific morbidity in the Croatian endemic area and Brod-Posavina County to be 13.95-fold and 3.78-fold the morbidity recorded at the national level, respectively. The standardized morbidity ratio also showed the risk of developing UUC in the Croatian endemic area to be 3.75-fold the risk in Brod-Posavina County and 16.4-fold the risk in Croatia.

Conclusions

These results showed that specific mortality and morbidity as well as standardized morbidity ratio and standardized mortality ratio were higher in Croatian endemic area than in Brod-Posavina County and Croatia.
Literatur
1.
Zurück zum Zitat Cˇeovic´ S, Miletic´-Medved M. Epidemiological features of endemic nephropathy in the focal area of Brodska Posavina, Croatia. In: Cˇvorišc´ec D, Cˇeovic´ S, Stavljenic´-Rukavina A, editors. Endemic nephropathy in Croatia. Academia croatica scientiarum medicarum. Zagreb: Medicinska naklada; 1996. pp. 7–21. Cˇeovic´ S, Miletic´-Medved M. Epidemiological features of endemic nephropathy in the focal area of Brodska Posavina, Croatia. In: Cˇvorišc´ec D, Cˇeovic´ S, Stavljenic´-Rukavina A, editors. Endemic nephropathy in Croatia. Academia croatica scientiarum medicarum. Zagreb: Medicinska naklada; 1996. pp. 7–21.
2.
Zurück zum Zitat Miletic´-Medved M, Domijan AM, Peraica M. Recent data on endemic nephropathy and related urothelial tumors in Croatia. Wien Klin Wochenschr. 2005;117(17):604–9.CrossRefPubMed Miletic´-Medved M, Domijan AM, Peraica M. Recent data on endemic nephropathy and related urothelial tumors in Croatia. Wien Klin Wochenschr. 2005;117(17):604–9.CrossRefPubMed
3.
Zurück zum Zitat Cˇeovic´ S, Hrabar A, Radonic´ M. An etiological approach to Balkan endemic nephropathy based on the investigation of two genetically different populations. Nephron. 1985;40:175–9.CrossRefPubMed Cˇeovic´ S, Hrabar A, Radonic´ M. An etiological approach to Balkan endemic nephropathy based on the investigation of two genetically different populations. Nephron. 1985;40:175–9.CrossRefPubMed
4.
Zurück zum Zitat Castegnaro M, Canadas D, Vrabcheva T, et al. Balkan endemic nephopathy: role of ochratoxins A through biomarkers. Mol Nutr Food Res. 2006;50:519–29.CrossRefPubMed Castegnaro M, Canadas D, Vrabcheva T, et al. Balkan endemic nephopathy: role of ochratoxins A through biomarkers. Mol Nutr Food Res. 2006;50:519–29.CrossRefPubMed
5.
Zurück zum Zitat Voice TC, Long DT, Radovanovic´ Z, et al. Critical evaluation of environmental exposure agents suspected in the etiology of Balkan endemic nephropathy. Int J Occup Environ Health. 2006;12(4):369–76.PubMed Voice TC, Long DT, Radovanovic´ Z, et al. Critical evaluation of environmental exposure agents suspected in the etiology of Balkan endemic nephropathy. Int J Occup Environ Health. 2006;12(4):369–76.PubMed
6.
Zurück zum Zitat Grollman AP, Shibutani S, Moriya M, et al. Aristolochic acid and the etiology of endemic (Balkan) nephropathy. Proc Natl Acad Sci USA. 2007;104:12129–34.CrossRefPubMed Grollman AP, Shibutani S, Moriya M, et al. Aristolochic acid and the etiology of endemic (Balkan) nephropathy. Proc Natl Acad Sci USA. 2007;104:12129–34.CrossRefPubMed
7.
Zurück zum Zitat Hranjec T, Kovacˇ A, Kos J, et al. Endemic nephropathy. The case for chronic poisoning by aristolochia. Croat Med J. 2005;46:116–25.PubMed Hranjec T, Kovacˇ A, Kos J, et al. Endemic nephropathy. The case for chronic poisoning by aristolochia. Croat Med J. 2005;46:116–25.PubMed
8.
Zurück zum Zitat Slade N, Moll UM, Brdar B, et al. p53 mutations as fingerprints for aristolochic acid: an environmental carcinogen in endemic (Balkan) nephropathy. Mutat Res. 2009;663:1–6.CrossRefPubMed Slade N, Moll UM, Brdar B, et al. p53 mutations as fingerprints for aristolochic acid: an environmental carcinogen in endemic (Balkan) nephropathy. Mutat Res. 2009;663:1–6.CrossRefPubMed
9.
Zurück zum Zitat Debelle FD, Vanherweghem JL, Nortier JL. Aristolochic acid nephropathy: a worldwide problem. Kidney Int. 2008;74(2):158–69.CrossRefPubMed Debelle FD, Vanherweghem JL, Nortier JL. Aristolochic acid nephropathy: a worldwide problem. Kidney Int. 2008;74(2):158–69.CrossRefPubMed
10.
Zurück zum Zitat Schmeiser HH, Kucab JE, Arlt VM, et al. Evidence of exposure to aristolochic acid in patients with urothelial cancer from a Balkan endemic nephropathy region of Romania. Environ Mol Mutagen. 2012;53:636–41. doi:10.1002/em.21732.CrossRefPubMed Schmeiser HH, Kucab JE, Arlt VM, et al. Evidence of exposure to aristolochic acid in patients with urothelial cancer from a Balkan endemic nephropathy region of Romania. Environ Mol Mutagen. 2012;53:636–41. doi:10.1002/em.21732.CrossRefPubMed
11.
Zurück zum Zitat Cosyns JP, Jadoul M, Squifflet JP, et al. Chinese herb nephropathy. A clue to Balkan endemic nephropathy. Kidney Int. 1994;45:1680–88.CrossRefPubMed Cosyns JP, Jadoul M, Squifflet JP, et al. Chinese herb nephropathy. A clue to Balkan endemic nephropathy. Kidney Int. 1994;45:1680–88.CrossRefPubMed
12.
Zurück zum Zitat Grollman AP, Scarborough J, Jelakovic´ B. Aristolochic acid nephropathy: an environmental and iatrogenic disease. Adv Mol Toxicol. 2009;3:211–27.CrossRef Grollman AP, Scarborough J, Jelakovic´ B. Aristolochic acid nephropathy: an environmental and iatrogenic disease. Adv Mol Toxicol. 2009;3:211–27.CrossRef
13.
Zurück zum Zitat Jelakovic´ B, Karanovic´ S, Vukovic´-Lela I, et al. Aristolactam-DNA adducts are a biomarker of environmental exposure to aristolochic acid. Kidney Int. 2012;81:559–67.CrossRefPubMed Jelakovic´ B, Karanovic´ S, Vukovic´-Lela I, et al. Aristolactam-DNA adducts are a biomarker of environmental exposure to aristolochic acid. Kidney Int. 2012;81:559–67.CrossRefPubMed
14.
Zurück zum Zitat Cvitkovic´ A, Vukovic´ Lela I, Edwards K, et al. Could disappearance of endemic (Balkan) nephropathy be expected in forthcoming decades. Kidney Blood Press Res. 2012;35:147–52.CrossRefPubMed Cvitkovic´ A, Vukovic´ Lela I, Edwards K, et al. Could disappearance of endemic (Balkan) nephropathy be expected in forthcoming decades. Kidney Blood Press Res. 2012;35:147–52.CrossRefPubMed
15.
Zurück zum Zitat Stefanovic´ V, Radovanovic´ Z. Balkan endemic nephropathy and associated urothelial cancer. Nat Clin Proct Urol. 2008;5(2):105–12.CrossRef Stefanovic´ V, Radovanovic´ Z. Balkan endemic nephropathy and associated urothelial cancer. Nat Clin Proct Urol. 2008;5(2):105–12.CrossRef
16.
Zurück zum Zitat Petronic´ VJ, Bukurov NS, Djokic´ MP, et al. Balkan endemic nephropathy and papillary transitional cell tumors of the renal pelvis and ureter. Kidney Int Suppl. 1991;34:S77–9. Petronic´ VJ, Bukurov NS, Djokic´ MP, et al. Balkan endemic nephropathy and papillary transitional cell tumors of the renal pelvis and ureter. Kidney Int Suppl. 1991;34:S77–9.
17.
Zurück zum Zitat Markovic´ N, Ignjatovic´ I, Cukuranovic´ R, et al. Decreasing incidence of urothelial cancer in a Balkan endemic nephropathy region in Serbia. A surgery based study from 1969 to 1998. Pathol Biol (Paris). 2005;53:26–9.CrossRef Markovic´ N, Ignjatovic´ I, Cukuranovic´ R, et al. Decreasing incidence of urothelial cancer in a Balkan endemic nephropathy region in Serbia. A surgery based study from 1969 to 1998. Pathol Biol (Paris). 2005;53:26–9.CrossRef
18.
Zurück zum Zitat Nikolic´ J. Altitude of settlements with the evidence of the endemic nephropathy and the upper urothelial tumors. In: Nikolic´ J, editor. Epidemic nephropathy and upper urothelial tumors. Beograd: Beograd AD; 2006. pp. 193–213. Nikolic´ J. Altitude of settlements with the evidence of the endemic nephropathy and the upper urothelial tumors. In: Nikolic´ J, editor. Epidemic nephropathy and upper urothelial tumors. Beograd: Beograd AD; 2006. pp. 193–213.
19.
Zurück zum Zitat Stefanovic V, Polenakovic M, Toncheva D. Urothelial carcinoma associated with Balkan endemic nephropathy. A worldwide disease. Pathol Biol (Paris). 2011;59(5):286–91.CrossRef Stefanovic V, Polenakovic M, Toncheva D. Urothelial carcinoma associated with Balkan endemic nephropathy. A worldwide disease. Pathol Biol (Paris). 2011;59(5):286–91.CrossRef
20.
Zurück zum Zitat Stefanovic´ V, Toncheva D, Atanasova S, Polenakovic´ M. Etiology of Balkan endemic nephropathy and associated urothelial cancer. Am J Nephrol. 2006;26:1–11.CrossRefPubMed Stefanovic´ V, Toncheva D, Atanasova S, Polenakovic´ M. Etiology of Balkan endemic nephropathy and associated urothelial cancer. Am J Nephrol. 2006;26:1–11.CrossRefPubMed
21.
Zurück zum Zitat Basic-Jukic N, Hrsak-Puljic I, Kes P, et al. Renal transplantation in patients with Balkan endemic nephropathy. Transplant Proc. 2007;39(5):1432–5.CrossRefPubMed Basic-Jukic N, Hrsak-Puljic I, Kes P, et al. Renal transplantation in patients with Balkan endemic nephropathy. Transplant Proc. 2007;39(5):1432–5.CrossRefPubMed
22.
Zurück zum Zitat Last JM. editor. A dictionary of epidemiology. 4th edn. New York: Oxford University Press; 2001. Last JM. editor. A dictionary of epidemiology. 4th edn. New York: Oxford University Press; 2001.
23.
Zurück zum Zitat Babuš V. Standardizirane i kumulativne stope. In: Babuš V, editor. Epidemiološke metode. Zagreb: Medicinska naklada; 2000. pp. 15–17. Babuš V. Standardizirane i kumulativne stope. In: Babuš V, editor. Epidemiološke metode. Zagreb: Medicinska naklada; 2000. pp. 15–17.
24.
Zurück zum Zitat Colin P, Koenig P, Ouzzane A, et al. Environmental factors involved in carcinogenesis of urothelial cell carcinomas of the upper urinary tract. BJU Int. 2009;104(10):1436–40.CrossRefPubMed Colin P, Koenig P, Ouzzane A, et al. Environmental factors involved in carcinogenesis of urothelial cell carcinomas of the upper urinary tract. BJU Int. 2009;104(10):1436–40.CrossRefPubMed
25.
Zurück zum Zitat Nikolic´ J, Djokic´ M, Ignjatovic I, Stefanovic V. Upper urothelial tumors in emigrants from Balkan endemic nephropathy areas in Serbia. Urol Int. 2006;77(3):240–4.CrossRefPubMed Nikolic´ J, Djokic´ M, Ignjatovic I, Stefanovic V. Upper urothelial tumors in emigrants from Balkan endemic nephropathy areas in Serbia. Urol Int. 2006;77(3):240–4.CrossRefPubMed
26.
Zurück zum Zitat Cˇukuranovic´ R, Ignjatovic´ M, Stefanovic´ V. Urinary tract tumors and Balkan endemic nephropathy in the South Morava River Basin. Kidney Int Suppl. 1991;34:S80–4.PubMed Cˇukuranovic´ R, Ignjatovic´ M, Stefanovic´ V. Urinary tract tumors and Balkan endemic nephropathy in the South Morava River Basin. Kidney Int Suppl. 1991;34:S80–4.PubMed
27.
Zurück zum Zitat Dimitrov PS, Simeonov VA, Stein AD. Balkan endemic nephropathy in Vratza, Bulgaria, 1964–1987, an epidemiologic analysis of population-based disease registers. Eur J Epidem. 2001;17:847–53.CrossRef Dimitrov PS, Simeonov VA, Stein AD. Balkan endemic nephropathy in Vratza, Bulgaria, 1964–1987, an epidemiologic analysis of population-based disease registers. Eur J Epidem. 2001;17:847–53.CrossRef
28.
Zurück zum Zitat Sostaric´ B, Vukelic´ M. Characteristics of urinary tract tumours in the area of Balkan endemicnephropathy in Croatia. IARC Sci Publ. 1991;(115):29–35. Sostaric´ B, Vukelic´ M. Characteristics of urinary tract tumours in the area of Balkan endemicnephropathy in Croatia. IARC Sci Publ. 1991;(115):29–35.
29.
Zurück zum Zitat Belicza M, Demirovic´ A, Tomic´ K, et al. Comparison of occurrence of upper urinary tract carcinomas in the region with endemic villages and non-endemic nephropathy region in Croatia. Coll Antropol. 2008;32:1203–7.PubMed Belicza M, Demirovic´ A, Tomic´ K, et al. Comparison of occurrence of upper urinary tract carcinomas in the region with endemic villages and non-endemic nephropathy region in Croatia. Coll Antropol. 2008;32:1203–7.PubMed
30.
Zurück zum Zitat Radovanovic´ Z, Jankovic´ S, Jevremovic´ I. Incidence of tumors of urinary organs in a focus of Balkan endemic nephropathy. Kidney Int Suppl. 1991;34:75–6. Radovanovic´ Z, Jankovic´ S, Jevremovic´ I. Incidence of tumors of urinary organs in a focus of Balkan endemic nephropathy. Kidney Int Suppl. 1991;34:75–6.
31.
Zurück zum Zitat Cukuranovic R, Ignjatovic I, Visnjic M, et al. Characteristics of upper urothelial carcinoma ina an area of Balkan endemic nephropathy in south Serbia. A fifty-year retrospective study. Tumori. 2010;96(5):674–9.PubMed Cukuranovic R, Ignjatovic I, Visnjic M, et al. Characteristics of upper urothelial carcinoma ina an area of Balkan endemic nephropathy in south Serbia. A fifty-year retrospective study. Tumori. 2010;96(5):674–9.PubMed
32.
Zurück zum Zitat Zivcic´-Cosic´ S, Grzetic´ M, Valencic´ M, et al. Urothelial cancer in patients with Endemic Balkan Nephropathy (EN) after renal transplantation. Ren Fail. 2007;29(7):861–5.CrossRefPubMed Zivcic´-Cosic´ S, Grzetic´ M, Valencic´ M, et al. Urothelial cancer in patients with Endemic Balkan Nephropathy (EN) after renal transplantation. Ren Fail. 2007;29(7):861–5.CrossRefPubMed
33.
Zurück zum Zitat Cˇeovic´ S, Pleština R, Miletic´-Medved M, Stavljenic´ A, Mitar J, Vukelic´ M. Epidemiological aspects of Balkan endemic nephropathy in a typical focus in Yugoslavia. IARC Sci Publ. 1991;115:5–10.PubMed Cˇeovic´ S, Pleština R, Miletic´-Medved M, Stavljenic´ A, Mitar J, Vukelic´ M. Epidemiological aspects of Balkan endemic nephropathy in a typical focus in Yugoslavia. IARC Sci Publ. 1991;115:5–10.PubMed
34.
Zurück zum Zitat Bukvic´ D, Jankovic´ S, Markovic´-Denic´ Lj. Descriptive and epidemiologic characteristics of patients with malignant upper urothelial tumors in the endemic area of Lazarevac. Srp Arh Celok Lek. 1999;127(11–12):371–5.PubMed Bukvic´ D, Jankovic´ S, Markovic´-Denic´ Lj. Descriptive and epidemiologic characteristics of patients with malignant upper urothelial tumors in the endemic area of Lazarevac. Srp Arh Celok Lek. 1999;127(11–12):371–5.PubMed
35.
Zurück zum Zitat Charbit L, Gendreau MC, Mee S, Cukier J. Tumors of the upper urinary tract: 10 years of experience. J Urol. 1991;146:1243–6.PubMed Charbit L, Gendreau MC, Mee S, Cukier J. Tumors of the upper urinary tract: 10 years of experience. J Urol. 1991;146:1243–6.PubMed
Metadaten
Titel
Upper urothelium carcinomas in Croatian endemic area
verfasst von
Ante Cvitković, PhD, MD
Igor Ivić-Hofman, MD
Dragana Jurić
Publikationsdatum
01.09.2013
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 17-18/2013
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-013-0412-5

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