A hidden danger in cancer patients: intestinal parasites

Intestinal parasites are a significant cause of morbidity and mortality in immunosuppressed individuals. This study aimed to evaluate the frequency, distribution, and associated clinical factors of intestinal parasite detection among patients with solid tumors who presented with diarrhea over a 10-year period.

This retrospective study included patients aged ≥18 years with solid tumors who presented with diarrhea and had stool samples examined at the Ege University Medical Parasitology Laboratory between January 2014 and September 2024. Patients with incomplete records or inadequate stool processing were excluded. Demographic, clinical, and treatment data were retrieved from electronic medical records and analyzed using SPSS version 22.0 (IBM Corp., Armonk, NY, USA).

Among 154 patients (mean age, 57.2 ± 16.3 years; 57.1% female), intestinal parasites were detected in 22.1% of patients (n = 34), with Cryptosporidium spp. (16.9%) and Entamoeba spp. or the E. histolytica/E. dispar complex (2.6%) being the most frequently identified organisms. Cryptosporidium spp. showed a borderline, nonsignificant trend toward a higher detection rate among patients with gastrointestinal system (GIS) malignancies (p = 0.067). No clinical or treatment-related variable was significantly associated with overall intestinal parasite detection in either categorical comparisons or univariate logistic regression. However, borderline, nonsignificant trends were observed for GIS malignancy (OR: 1.994; 95% CI: 0.917-4.336; p = 0.079) and recent hospitalization (OR: 0.482; 95% CI: 0.221-1.050; p = 0.066). In patients with available follow-up, clinical improvement was observed after antiparasitic or symptomatic treatment.

Among patients with solid tumors presenting with diarrhea, intestinal parasitic infections should be considered in the differential diagnosis. Early parasitological evaluation and increased oncologist awareness may facilitate timely treatment, symptom control, and prevention of complications.