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The Etiology of Bladder Cancer from the Epidemiological Viewpoint¹

Epidemiology Unit, National Cancer Institute of Canada, University of Toronto, 121 St. Joseph Street, Toronto, Ontario, M5S 2R9, Canada

A number of causal environmental factors have been identified for bladder cancer. Quantification of the extent to which known and suspect factors account for the cases that occur is one of the current goals of research in bladder cancer epidemiology.

Certain occupational groups have been identified for which a clearly increased risk has been demonstrated; smoking has also been demonstrated as a risk factor. Of the residual, due to presently unknown factors, it has been pointed out that possibly as much as one-half of the males and maybe two-thirds of the females could be accounted for by coffee drinking.

Preliminary analysis of a case-control study conducted in Canada has confirmed the importance of cigarette smoking in both sexes, and has indicated a slightly increased risk due to consumption of regular coffee in males and due to heavy use of instant coffee in both sexes. These risks are only partially accounted for by an association between smoking and coffee drinking.

Although possibly most of the risk factors have been identified for bladder cancer in males, in females it still seems likely that a number of substances to which the general population is exposed may be found to be carcinogenic to the bladder.

¹ Presented at the National Bladder Cancer Conference, November 28 to December 1, 1976, Miami Beach, Fla.

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