Selected risk factors for transitional cell bladder cancer

Cancer of the bladder has long been associated with environmental risk factors, such as occupational hazards and smoking. The aim of the current study was to evaluate the contribution of known risk factors on a community basis in the 1990s, in view of the recent worldwide efforts to control environmental hazards. The study population included 140 male patients and 280 matched controls. Information on demographic data, occupational exposure, smoking habits and disease history was obtained by personal interviews. Our study confirmed the role of industrial occupation (OR = 2.21; 95% Cl = 1.21-4.02) and exposure to 3 or more metals (OR = 3.65; 95% Cl = 1.21-11.08) as risk factors. Prostate enlargement was also found significant, but probably not causal (OR = 2.23; 95% Cl = 1.29-3.87). Surprisingly, smoking showed only an inconsistent association with higher rates among those who started to smoke before 18 years of age (OR = 2.64; 95% Cl = 1.4-4.99) and those who smoked more than 30 cigarettes per day (OR = 1.82; 95% Cl = 0.95-3.49). The above data suggest that current efforts to reduce the load of bladder cancer in the population, via environmental measures, have not as yet yielded significant effects.