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Background:Bladder carcinoma is the sixth-most common cancer in the USA, and the majority of these tumors are non-invasive stage Ta at first diagnosis without evidence of invasion
In 2018, there is an estimated 81,190 new bladder cancer (BC) cases diagnosed in the USA with 17,240 deaths. Three-quarters of new cases occur in men (higher in some regions and reflects smoking and occupational differences and access to healthcare), women have greater disease-specific mortality. Reasons for the disparity in gender incidence and mortality include differences in hormonal profiles (activity and levels of the sex steroid hormone pathway) and differences in the timelines of female referrals to investigation from primary care
In Egypt, bladder cancer accounts for about 30% of all cancers, and it is the most common malignancy in men and the second most common malignancy in women after breast cancer, it has been related to chronic infection with Schistosoma haematobium, causing mainly squamous cell carcinoma (SCC).In the current era of precision molecular medicine, there is a growing need for identiﬁcation and validation of biomarkers that can assist in patient selection by accurately predicting treatment response. As the resources in the worldwide health care system are ﬁnite, the search for the best possible criteria of analysis is indispensable to optimize cost-beneﬁt ratio in the treatment of cancers including the bladder cancer. Can the highly successful scenario of breast cancer be developed and implemented for the treatment of bladder cancer where the newly recognized subtypes can be reliably identiﬁed by using a panel of immunohistochemical stains.