Abstract
In the Mediterranean region of France where bladder cancer mortality and incidence are high, a case-control study with 219 male incident cases and 794 randomized, male population-controls was carried out in 1987–89 to investigate bladder cancer risk factors and more specifically, regional factors. A stepwise logistic regression was applied to the data. This investigation confirms the role of tobacco and of certain occupational exposures in bladder carcinogenesis. There was a significant dose-response relationship with lifelong coffee drinking and alcohol consumption; however the risk estimates were only significantly elevated for the heaviest drinkers. The intake of saccharin was not associated with risk of bladder cancer. Infrequent consumption of carrots, spinach, and marrows conferred an increased risk, suggesting a protective effect of vitamin A. Finally, this investigation results in some new hypotheses. The study of residences and birthplaces has revealed a lower risk for those who have lived in a non-Mediterranean area and a higher risk for those born in a Mediterranean area. These features might be explained by some Mediterranean dietary habits, such as a high consumption of spices (odds ratio =3.64, 95 percent confidence interval=2.21–5.98).
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Rezvani A, Doyon F, Flamant R.Atlas de la Mortalité par Cancer en France (1971–1978). Paris, France: Editions INSERM, 1986.
Daurès JP.Le Cancer dans l'Hérault 1985. Montpellier, France: Registre des tumeurs, 1986.
Breslow NE, Day NE.Statistical Methods in Cancer Research, the Analysis of Case-control Studies. Vol. 1. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No. 32.
Bollack C, Poyot G. Epidemiological study of 314 cases of cancer of the bladder in the administrative department of Bas-Rhin, France.Urol Res 1979;7: 127–30.
Wynder EL, Goldsmith R. The epidemiology of bladder cancer.Cancer 1977;40: 1246–68.
Cartwright RA, Adib R, Appleyard I, et al., Cigarette smoking and bladder cancer: an epidemiological inquiry in West Yorkshire.J Epidemiol Community Health 1983;37: 256–63.
Clavel J, Cordier S, Boccon-Gibod L, Hémon D. Tobacco and bladder cancer in males: increased risk for inhalers and smokers of black tobacco.Int J Cancer 1989;44: 605–10.
Cole P, Monson RR, Haning H, Friedell GH. Smoking and cancer of the lower urinary tract.N Engl J Med 1971;284: 129–34.
Gonzalez CA, Lopez-Abente G, Errezola M, et al. Occupation, tobacco use, coffee, and bladder cancer in the county of Mataro (Spain).Cancer 1985;55: 2031–4.
Lopez-Abente G, Gonzalez CA, Errezola M, et al. Tobacco smoke inhalation pattern, tobacco type, and bladder cancer in Spain.Am J Epidemiol 1991;134: 830–9.
Howe GR, Burch JD, Miller AB, et al. Tobacco use, occupation, coffee, various nutrients, and bladder cancer.JNCI 1980;64: 701–13.
Iscovich J, Castelletto R, Esteve J, et al. Tobacco smoking, occupational exposure and bladder cancer in Argentina.Int J Cancer 1987;40: 734–40.
Marrett LD, Meigs JW, Flannery JT. Bladder cancer in Connecticut: the role of cigarette smoking and other risk factors.Connecticut Med 1985;49: 718–26.
Miller CT, Neutel CI, Nair RC, et al. Relative importance of risk factors in bladder carcinogenesis.J Chronic Dis 1978;31: 51–7.
Mommsen S, Aagaard J. Tobacco as a risk factor in bladder cancer.Carcinogenesis 1983;4: 335–8.
Morgan RW, Jain MG. Bladder cancer: smoking, beverages and artificial sweeteners.Can Med Assoc J 1974;111: 1067–70.
Morrison AS, Buring JE, Verhock WG, et al. An international study of smoking and bladder cancer.J Urol 1984;131: 650–4.
Najem GR, Louria DB, Seebode JJ, et al.. Life time occupation, smoking, caffeine, saccharine, hair dyes and bladder carcinogenesis.Int J Epidemiol 1982;11: 212–7.
Rebelakos A, Trichopoulos D, Tzonou A, et al. Tobacco smoking, coffee drinking, and occupation as risk factors for bladder cancer in Greece.JNCI 1985;75: 455–61.
Vineis P, Frea B, Uberti E, Ghisetti V, Terracini B Bladder cancer and cigarette smoking in males: a case-control study.Tumori 1983;69: 17–22.
Vineis P, Esteve J, Terracini B. Bladder cancer and smoking in males: types of cigarettes, age at start, effect of stopping and interaction with occupation.Int J Cancer 1984;34: 165–70.
Vineis P, Esteve J, Hartge P, et al. Effects of timing and type of tobacco in cigarettes-induced bladder cancer.Cancer Res 1988;48: 3849–52.
Wynder EL, Augustine A, Kabat GC, et al. Effect of the type of cigarette smoked on bladder cancer riskCancer 1988;61: 622–7.
Bryant MS, Vineis P, Skipper PL, Tannenbaum SR. Hemoglobin adducts of aromatic amines: associations with smoking status and type of tobacco.Proc Natl Acad Sci USA 1988;85: 9788–91.
Mohtashamipur E, Norpoth K, Lieder F. Urinary excretion of mutagens in smokers of cigarettes with various tar and nicotine vields, black tobacco and cigars.Cancer Lett 1987;34: 103–12.
Claude JC, Frentzel-Beyme RR, Kunze E. Occupation and risk of cancer of the lower urinary tract among men. A case-control study.Int J Cancer 1988;41: 371–9.
Schoenberg JB, Stemhagen A, Mogielnicki AP, et al. Case-control study of bladder cancer in New Jersey. Occupational exposures in white males.JNCI 1984;72: 973–81.
Brownson RC, Chang JC, Davis JR. Occupation, smoking and alcohol in the epidemiology of bladder cancer.Am J Public Health 1987;77: 1298–300.
Gonzalez CA, Lopez-Abente G, Errezola M, et al. Occupation and bladder cancer in Spain: a multi-centre case-control study.Int J Epidemiol 1989;18: 569–77.
Silverman DT, Hoover RN, Albert S, Graff KM. Occupation and cancer of the lower urinary tract in Detroit.JNCI 1983;70: 237–45.
Smith EM, Miller ER, Woolson RF, Brown CK. Bladder cancer risk among auto and truck mechanics and chemically related occupations.Am J Public Health 1985;75: 881–3.
Vineis P, Magnani C. Occupation and bladder cancer in males: a case-control study.Int J Cancer 1985;35: 599–606.
Silverman DT, Hoover RN, Mason TJ, Swanson GM. Motor exhaust-related occupations and bladder cancer.Cancer Res 1986;46: 2113–6.
Hoar SK, Hoover R. Truck driving and bladder cancer mortality in rural New England.JNCI 1985;74: 771–4.
Boyko RW, Cartwright RA, Glashan RW. Bladder cancer in dye manufacturing workers.J Occup Med 1985;27: 799–803.
Schulte PA, Ringen K, Hemstreet GP, et al. Risk factors for bladder cancer in a cohort exposed to aromatic amines.Cancer 1986;58: 2156–62.
Cole P, Hoover R, Friedell GH. Occupation and cancer of the lower urinary tract.Cancer 1972;29: 1250–60.
Cole P. Coffee drinking and cancer of the lower urinary tract.Lancet 1971;i: 1335–7.
Fraumeni JF Jr., Scotto J, Dunham LJ. Coffee drinking and bladder cancer.Lancet 1971;ii: 1204.
Bross ID, Tidings J. Another look at coffee drinking and cancer of the urinary bladder.Prev Med 1973;2: 445–51.
Morrison AS, Buring JE, Verhoek WG, et al. Coffee drinking and cancer of the lower urinary tract.JNCI 1982;68: 91–4.
Risch HA, Burch JD, Miller AB, et al. Dietary factors and the incidence of cancer of the urinary bladder.Am J Epidemiol 1988;127: 1179–91.
Cartwright RA, Adib R, Glashan R, Gray BK. The epidemiology of bladder cancer in West Yorkshire. A preliminary report of non-occupational aetiologies.Carcinogenesis 1981;2: 343–7.
Jensen OM, Wahrendorf J, Knudsen JB, Sorensen BL. The Copenhagen case-control study of bladder cancer. Effect of coffee and other beverages.Int J Cancer 1986;37: 651–7.
Viscoli CM, Lachs MS, Horwitz RI. Bladder cancer and coffee drinking: a summary of case-control research.Lancet 1993;341: 1432–7.
Escolar Pujolar A, Gonzalez CA, Lopez-Abente G, et al. Bladder cancer and coffee consumption in smokers and non-smokers in Spain.Int J Epidemiol 1993;22: 38–44.
Marrett LD, Walter SD and Meigs JW. Coffee drinking and bladder cancer in Connecticut.Am J Epidemiol 1983;117: 113–27.
Thomas DB, Uhl CN, Hartge P. Bladder cancer and alcoholic beverage consumption.Am J Epidemiol 1983;118: 720–7.
Bravo MP, Calero JDR, Conde M. Bladder cancer and the consumption of alcoholic beverages in Spain.Eur J Epidemiol 1987;3: 365–9.
Morrison AS, Buring J. Artificial sweeteners and cancer of the lower urinary tract.N Engl J Med 1980;302: 537–41.
Hoover R, Strasser PH. Artificial sweeteners and human bladder cancer: preliminary results.Lancet 1980;i: 837–40.
Morrison AS, Verhoek WG, Leck I, et al. Artificial sweeteners and bladder cancer in Manchester, UK, and Nagoya, Japan.Br J Cancer 1982;45: 332–6.
Howe GR, Burch JD, Miller AB, et al. Artificial sweeteners and human bladder cancer.Lancet 1977;ii: 578–81.
Mettlin C, Graham S. Dietary risk factors in human bladder cancer.Am J Epidemiol 1979;110: 255–63.
Kolonel LN, Hinds MW, Nomura AMY, et al. Relationship of dietary vitamin A and ascorbic acid intake to the risk for cancers of the lung, bladder and prostate in Hawaii.Natl Cancer Inst Monogr 1985;69: 137–42.
Paganini-Hill A, Chao A, Ross RK, et al. Vitamin A, beta-carotene and the risk of cancer: a prospective study.JNCI 1987;79: 443–8.
Sporn MB, Roberts AB. Role of retinoids in differentiation and carcinogenesis.Cancer Res 1983;43: 3034–40.
Peto R, Doll R, Buckley JD, et al. Can dietary betacarotene materially reduce human cancer rates?Nature 1981;290: 201–8.
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This study was supported by a grant from the Institut National de la Santé et de la Recherche Médicale (INSERM).
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Momas, I., Daurès, JP., Festy, B. et al. Relative importance of risk factors in bladder carcinogenesis: some new results about Mediterranean habits. Cancer Causes Control 5, 326–332 (1994). https://doi.org/10.1007/BF01804983
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DOI: https://doi.org/10.1007/BF01804983