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Serology in the study of the relationship between S. haematobium infestation and cancer of the urinary bladder.

SUMMARY 
 
In this investigation we have demonstrated the value of serological diagnosis of bilharziasis and the extent of the association of this disease with cancer of the bladder in endemic areas. Fifty-two patients suffering from carcinoma of the urinary bladder were investigated. Although 40 of them gave a history of bilharziasis only 6 excreted ova in their urine. On account of this finding, we employed the complement fixation test and the circumovum precipitin test to find out the extent of association of bilharzial infestation with cancer of the bladder. The results were as follows: Of 52 patients, 46 proved positive for the C.F.T. while 4 were negative and 2 gave an anti-complementary reaction. Forty-four out of 45 patients of the same series proved positive for the C.O.P.T. All the 6 patients who passed ova in their urine were also positive for both serological tests. The absence of eggs from the majority of the cancer patients urine may be due to the long duration of infestation in such cases. Gelfand et al. (1967) investigating the relation between carcinoma of the bladder and infestation with S. haematobium, stated that in bilharziasis of long standing, ova may be absent from the bladder. In order to overcome this difficulty they examined rectal biopsies in cases of bladder cancer and controls, as these are frequently positive in cases of vesical bilharziasis. 
 
 
 
The present work has emphasised the close association between infestation with S. haematobium and cancer of the bladder. It has also suggested that in future surveys of this nature the most practical methods would be exfoliative cytology for the detection of carcinoma combined with serological tests and the detection of ova in urine for the diagnosis of Bilharziasis haematobium.