ABSTRACT
This chapter summarizes the knowledge on the relationship between schistosomiasis and vesical cancer and the pathological characteristics of the neoplastic state. The association between urinary schistosomiasis and bladder cancer defines a distinct clinicopathologic entity quite different from that experienced in the Western World. Schistosomiasis tends to reach its highest prevalence and severity where agriculture depends on irrigation such as Egypt, with a rate of 17 to 60% in rural areas. The nature of the carcinogen and the mechanism of carcinogenesis in schistosomal bladder carcinoma are still unknown, and possibly multiple factors are involved. Chronic urinary schistosomiasis is usually complicated by various metaplastic and proliferative changes in the bladder epithelium which are also frequently present in patients with established bladder carcinoma. Urothelial hyperplasia invariably accompanies chronic schistosomal cystitis and bladder carcinoma. A correlation of the epithelial abnormalities with the existing carcinoma helps to clarify the evolution as well as the distinctive histopathology of carcinoma in the schistosomal bladder.
