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 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