Researchers from the National Cancer Institute and Dartmouth Medical School have reported that the risk of developing smoking-related bladder cancer has increased in New Hampshire over the risk observed in the 1990s. The details of this study appeared in the November 18, 2009 issue of the Journal of the National Cancer Institute.[1]
The risk of developing bladder cancer increases with age, and men are more commonly affected than women. Because smoking has been linked with an increased risk of bladder cancer, researchers continue to evaluate specific aspects of smoking in relation to bladder cancer risk. A European multicenter study has recently determined that individuals who smoke and children who are exposed to second-hand smoke are at an increased risk of developing bladder cancer.
The overall risk of bladder cancer in relation to smoking was calculated from 1,170 patients with bladder cancer and 1,413 controls from Maine, New Hampshire, and Vermont. For smokers there was a threefold risk of developing bladder cancer for ever-smokers and a fivefold risk for current smokers compared with never-smokers.
The risk of bladder cancer over time was determined from data from New Hampshire. This part of the study evaluated the risk of bladder cancer in two time periods: 1994-1998 (305 patients with bladder cancer and 335 controls) and 1998-2001 (843 patients with bladder cancer and 1,183 controls). The following table shows the odds ratio for developing bladder cancer in three different time periods for former smokers and current smokers compared with non-smokers:
Table 1: Odds for Developing Bladder Cancer Among Smokers
Time period | Former Smoker | Current Smoker |
1994-1998 | 1.4 | 2.9 |
1998-2001 | 2.0 | 4.2 |
2002-2004 | 2.6 | 5.5 |
There was a higher risk of developing bladder cancer in patients who smoked fewer cigarettes over a longer period of time versus the same number of cigarettes over a shorter period of time.
Comments: An accompanying editorial points out that the increased risk of bladder cancer with smoking could be due to changes in the contents of cigarettes over time.[2] They stated, “So far, the changing carcinogenic properties of cigarettes have been studied most extensively for lung cancer, and it is known that this has increased over time.” They also stated, “This study highlights the need for continued vigilance in monitoring the impact of changing cigarette content and design on disease risk, and demonstrates that the public health implications of the changing cigarette content and design are potentially severe.”
References:
[1] Baris D, Karagas MR, Verrill C, et al. A case-control study of smoking and bladder cancer risk: Emergent patterns over time. Journal of the National Cancer Institute. 2009;101:1553-1561.
[2] Alberg AJ, Hebert JR. Cigarette smoking a bladder cancer: A new twist to an old saga. Journal of the National Cancer Institute. 2009;101:1525-1526.
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