Bladder Cancer in Iraq: The Histological Subtypes and their Relationship to Schistosomiasis

Abstract

A total of 1216 cases of urinary bladder cancer in Iraq were evaluated for histological type and association with schistosomiasis. The detection rate of schistosomal ova was only about 30%. About half of the cases were squamous cell carcinomas and there was a high frequency of schistosomiasis. The other half of the cases were mostly transitional cell carcinomas, and these were associated with a low incidence of Schistosoma. Only 4.7% of the papillary type were associated with schistosomiasis, and this parallels the incidence of schistosomiasis in our autopsy series and in the adult Iraqi population as a whole. The spectrum of metaplasia-dysplasia-careinoma in situ was observed in the urinary bladder biopsies from patients with schistosomiasis, even in the absence of invasive cancer. In our study, and for most likely the first time in an Iraqi series, we included 87 cases in which biopsy specimens were obtained at cystectomy. In the remaining cases, specimens were obtained during transurethral cystoscopy. Careful histopathological study of these cases helped to clarify many of the questions about the relationship between urinary bladder cancer and schistosomiasis in the Iraqi population.

Bilharzial and Nonbilharzial Bladder Cancer in Asir: A Comparative Clinicopathological Study

“…23% SCC, and 4% adenocarcinoma, contrasting with those from Iraq where SCC and TCC formed 46% and 43%, respectively. However, similar to our study, 72% of BC in Iraq was SCC [4]. A high incidence of SCC was also reported from Zambia (71%) and Egypt where SCC forms 68% of bilharzial and 50% of nonbilharzial cancers [2,5,15].…”

“…A high incidence of SCC was also reported from Zambia (71%) and Egypt where SCC forms 68% of bilharzial and 50% of nonbilharzial cancers [2,5,15]. We had no patients with TCC in the bilharzial group contrasting with 16-25% TCC reported from other endemic areas [2,4,5]. However, in view of our hospital-based study with relatively fewer number of cases, comparison may not be adequately valid.…”

“…BC is not a common problem of the highland where the water supply comes from the desalination plant and deep wells as opposed to the lowland bilharzial areas where water ponds prevail. The 21% BC rate is in keeping with studies from Iraq and Zambia where it varies from 17-32% [4,5,7] and is nowhere near the 75-84% from Egypt [1,15]. In our study, 13/48 patients were inhabitants of the endemic bilharzial area of lowlands.…”

“…SD Shetty, AIA Ibrahim, KP Patil, NA Morad, N Anandan, P Khurana, Bilharzial and Nonbilharzial Bladder Cancer in Asir: A Comparative Clinicopathological Study. 1993; 13(2): 151-154 The association between urinary bilharziasis and bladder cancer is well documented [1][2][3][4][5]. The high incidence of bladder cancer with urinary bilharziasis in Egypt contrasts with the lower figures from other bilharzial endemic areas such as Sudan, Zambia,.…”

“…The association between urinary bilharziasis and bladder cancer is well documented [1][2][3][4][5]. The high incidence of bladder cancer with urinary bilharziasis in Egypt contrasts with the lower figures from other bilharzial endemic areas such as Sudan, Zambia, and Iraq [4][5][6][7].…”