The changing patterns of bladder cancer in Egypt over the past 26 years

Abstract

Objective-To evaluate temporal changes in histopathological types of bladder cancer and to assess associated changes in demographic, epidemiologic, and lifestyle risk factors.Methods-We abstracted data from all available medical records from the National Cancer Institute of Cairo University (NCI-Cairo). Six calendar years representing 5-year periods between 1980 and 2005 were evaluated. Information on demographics, schistosomal infection, clinical symptoms of bladder cancer, and tumor pathology was abstracted.Results-During this 26-year period, important changes in the frequency of histopathological types of bladder cancer occurred. We found a statistically significant association between time period of diagnosis and histopathological type. Patients diagnosed in 2005 had a sixfold higher odds associated with transitional cell carcinoma compared to those patients diagnosed in 1980 (odds ratio (OR) 6.00 (95% CI 4.00-8.97)).Conclusions-These data strongly suggest that the histopathological profile of bladder cancer in Egypt has changed significantly over the past 26 years. Historically, squamous cell carcinoma was the predominant form of bladder cancer in Egypt; however transitional cell carcinoma has become the most frequent type. These results corroborate findings from a few small-scale hospital-based studies which conclude that the etiology of bladder cancer in Egypt has changed significantly over the past 26 years.

Tumour-like phenotypes in urothelial cells after exposure to antigens from eggs of Schistosoma haematobium: An oestrogen–DNA adducts mediated pathway?

“…A S. haematobium-associated bladder cancer incidence of 3-4 cases per 100,000 has been estimated (Shiff et al, 2006). Felix et al (2008) showed that the occurrence of transitional cell carcinoma (TCC) of the bladder has supplanted SCC in Egypt following a major decline in the prevalence of urinary schistosomiasis. Such a decline in the pattern of this infection suggests the importance of schistosome-associated bladder cancer that, elsewhere, may be more widespread than is presently thought (Shiff et al, 2010).…”

A Clinicopathological Study of Various Lesions Encountered in Cystoscopic Bladder Biopsies

“…Histopathologically, they show more than seven layer thick urothelium with cells without any cytological atypia. (13,16,17) On the contrary, low-grade papillary urothelial carcinoma will show thickened urothelium with papillary fronds with minimum cytological atypia. (3,4,6,18) Very rarely these lowgrade tumour would also recur if there was an evidence of invasion.…”

Urinary schistosomiasis

“…A fall in the prevalence rate of schistosomiasis from 1980 to 2005 due to a public health intervention was followed by a six-fold lower rate of SCC, clearly suggesting a cause and effect relationship [24].…”