Schistosomiasis and bladder cancer: similarities and differences from urothelial cancer

Abstract

Through the years, schistosoma-associated bladder cancer was believed to be a unique entity of disease, different from urothelial cancer. As carcinogenesis is a highly complex process resulting from the accumulation of many genetic and epigenetic changes leading to alterations in the cell proliferation and regulation process, confirmation of their minute differences or similarities are extremely difficult. In bladder cancer, many of these carcinogenic cascades were not fully documented in spite of the efforts undertaken. The control of schistosomiasis and the subsequent decrease in the intensity of infestation showed feature changes approaching that of urothelial tumors. However, schistosoma-associated bladder cancer still presents in more advanced stages than schistosoma-non-associated urothelial cancer. Furthermore, many data were collected proving that, upon applying the same treatment protocol and management care, stage-by-stage comparison of the treatment end results were found to be similar in bladder cancer patients with the different etiologies.

Expression of Engrailed-2 (EN2) protein in bladder cancer and its potential utility as a urinary diagnostic biomarker

“…This is currently being investigated by our group. Squamous cell histology is common in countries where bladder cancer is associated with schistosomiasis 13 and therefore EN2 may be useful in this high risk population, in contrast with other currently used markers which have been shown to be more specific for TCC histology.…”

Alterations in DNA Methylation May Be the Key to Early Detection and Treatment of Schistosomal Bladder Cancer

“…Although S . haematobium is an accepted bladder carcinogen, many patients with schistosomal bladder cancer present at advanced stages [ 4 ]. We posit that this is due to a combination of poor medical infrastructure in endemic areas and a lack of diagnostic and prognostic tools for schistosomal bladder cancer and its precursor epigenetic events.…”

Environmental non-occupational risk factors associated with bladder cancer

“…Besides the underlying mechanisms discussed in the bacterial cystitis, egg deposits cause urinary bladder stasis, and parasitic antigens are immunosuppressive. 4,25,32 Also papillomavirus (HPV) and polyomavirus (BKV and JVC) are associated with increased risk of BC, but the scientific evidence for this is less. 5,25,33 High carcinogenic risk papillomavirus transfer to mucosal cells E6 and E7 genes, which encode oncoproteins that disrupt the cell cycle, the maintenance of telomerase and regulation of apoptosis.…”