Objectives: This study was done to evaluate the role of smoking in high- and low-grade urothelial carcinoma. Study design: Cross-sectional descriptive study Study setting: This cross-sectional study was done at the Department of histopathology, Liaquat University of Medical and Health sciences, Jamshoro, Pakistan. Methods: Total 165 cases of urothelial carcinoma were included in this study. The clinical history of patients was taken from computer storage data followed by review of microscopic slides by two histopathologists. Excel 2021 and SPSS 22 were used for statistical analysis. Results: A total of 165 cases were enrolled in the study. 55.15% (n=91) were smokers. Smoking history was positive in most cases of low-grade urothelial carcinoma. Follow up of patients was taken at 24 months after biopsy or resection of tumor. Patient with high grade urothelial carcinoma poor outcome i.e., 53.3% dead at the follow up taken at 24 months. Conclusion: In conclusion, urothelial carcinoma is an aggressive malignancy which has strong association with smoking. Patients with positive smoking history present with higher stage and grade of disease. Early intervention in form of strict follow up and smoking cessation should be done in patients to ensure prompt treatment. Keywords: High grade urothelial carcinoma, Low grade urothelial carcinoma, Smoking
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