Ashley Felix

bladder cancer in Egypt

OBJECTIVE: The objective of this study was to evaluate the possible changes in the frequency of histopathological types of bladder cancer in Egypt over the past 25 years. The study also aimed at evaluating the possible changes in the distribution of demographic, epidemiologic, and lifestyle risk factors that were associated with this possible change in the histopathological types.

METHODS: We reviewed all available medical records from one calendar year representing each 5-year period between 1980 and 2005. Data abstracted from the medical records included information on demographics, such as age, sex, and residence, smoking status, schistosomiasis infection, clinical symptoms of bladder cancer and schistosomiasis, and tumor pathology. Preliminary data analyses included simple descriptive statistics.

RESULTS: Between 1980 and 2005 a shift in the frequency of histopathological types occurred at the National Cancer Institute at Cairo University; in 1980, 1983, and 1990 (the first 3 years of the study) the ratio of squamous cell carcinoma (SCC) to transitional cell carcinoma (TCC) was greater than 1, indicating SCC was the more prevalent form of the bladder tumor. In 1994, 2001, and 2005 (the last 3 years of the study), the ratio of SCC to TCC was less than 1 signifying that transitional cell carcinoma became the principal form of the bladder tumor. Additionally, the prevalence of schistosomiasis infection in bladder cancer patients decreased from 49.45% to 40.23% over the 25 year period. Although data on smoking habits was largely unavailable within the medical records, population level statistics indicate that the prevalence of cigarette smoking is increasing.

CONCLUSIONS: These data suggest that the histopathology of bladder cancer in Egypt has changed significantly over the past 25 years. Historically, squamous cell carcinoma of the urinary bladder was the predominant form of bladder cancer in Egypt, however a shift has occurred, implicating transitional cell carcinoma as the primary cell type. Furthermore, this study corroborates the existing literature which state that schistosomiasis infection in Egypt is declining while smoking rates are becoming more important in the etiology of bladder cancer in Egypt.