Neoplastic and preneoplastic conditions of the large bowel in Iraq

pathological material from [532] patients with colo-rectal disease encountered during a 10- Year period [1981-1990] were reviewed. Colo-rectal carcinoma was diagnosed in [320] patients and was associated in 8.6% of patients with adenomatous polyps and in 1.4% with ulcerative colitis. The overall incidence of adenomatous polyps in this study was [6%]. Increasing size and villous pattern in adenomas correlated with higher incidence of severe dysplasia

Risk factors in bladder cancer of Iraqi patients

A total of 135 bladder cancer patients diagnosed during eight monthes at the Medical City Hospital, were studied to determine the pathological subtypes, and the possible risk factors. Squamous cell carcinoma formed 41%, transitional cell carcinoma 47%, and adenocarcinoma formed 9%. Bilharzial ova were detected in tissue section of 32% of the cases [43 patients]. The histological analysis of bladder cancer associated with bilhariasis showed significantly different pattern i.e. squamous cell carcinoma forms 72%, papillary transitional cell carcinoma 2.8% non papillary transitional cell 9.3%, and adenocarcinoma forms 16.3%.Regarding the geographical distribution of various histological types; the squamous cell carcinoma predominated in patients coming from the middle and south of the country [44% and 45% respectively], while being rare in the north [8.3%]. This distribution is similar to endemicity pattern of bilhariziasis in Iraqi. The occupational hazard detected was peasantry. Smoking was significantly more common in bladder cancer not associated with bilhariziasis, as well as in bladder patients with papillary transitional cell carcinoma. Past history of recurrent urinary tract infection was common in bladder cancer associated with schistosmiasis [69%], while those associated with past history of urolithiasis were observed in only 29%

Bladder cancer in Iraq: the histological subtypes and their relationship to schistosomiasis

A total of 1216 cases of urinary bladder cancer in Iraq were evaluated for histological and association with schistosomiasis. The detection rate of schistosomal ova was only about 30%. About half of the cases were squamous cell carcinoma and there was a high frequency of schitosomiasis. 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 our autopsy series and in the adult Iraqi as a whole. The spectrum of metaplasia-dysplasia-carcinoma 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 causes 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