BEN and Upper Urothelial Tumors Altitude Dependant Diseases

by J. Nilolić, D. Narić, Z. Ivanović, D. Todorović and D. Crnomarković

abstract of article presented at the XII International Conference "Danube - River of Cooperation" (October, 11-14 2001) and published in Danubius 1-2/2001

Some (10-30%) of Balkan Endemic Nephropathy (BEN) patients develop tumors of Upper Urothelium (UUT). There is a clear correlation between BEN incidence and UUT incidence. There is no village where only one of the two diseases is present. In the villages most affected with BEN the UUT incidence is the greatest. So, UUT are a good "marker" to follow up BEN territorial distribution, incidence, time trend etc.

In Bulgaria no correlation was established between altitude and BEN incidence (Gabev 1972). In region Lazarevac, Lajkovac, Barajevo clear altitude/BEN incidence correlation was found (Nikolić 2000). In this paper another region is observed.

We analyzed 220 UUT cases operated in the period 1969 - 1998 yr. Patients are living in region 90 km south east from Belgrade (communities of V.Plana, M. Crnice and Žabari, 46 villages, 90437 inhabitants). There were 82 males and 138 females with average age X = 65,45 yrs.

Tumor incidence is compared with the village altitude.

Villages are divided in four incidence groups. First, hyperendemic with UUT incidence - one tumour case in less than 99 inhabitantis per 30 yrs. Second endemic villages (100-299 inhabit./tumor, per 30 yrs) and third, hypoendemic (300-999 inhabit/tumor, per 30 yrs). Fourth group of 12 villages (7.807 inhabit.) in observed period were without single UUT.

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