This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vecchia, C. L. Articles by Franceschi, S. Search for Related Content PubMed PubMed Citation Articles by Vecchia, C. L. Articles by Franceschi, S.

Genital and Urinary Tract Diseases and Bladder Cancer¹

Istituto di Ricerche Farmacologiche "Mario Negri," 20157 Milan, Italy [C. L. V., E. N., B. D., R. S.]; Institute of Social and Preventive Medicine, University of Lausanne, 1005 Lausanne, Switzerland [C. L. V.]; and Aviano Cancer Centre, 33081 Aviano, Pordenone, Italy [S. F.]

The relationship between selected urinary tract and genital diseases and the risk of bladder cancer was analyzed using data from a case-control study of 364 cases of bladder cancer and 447 controls hospitalized for acute, nonneoplastic, nongenital tract conditions, unrelated to known or suspected risk factors for bladder cancer. Cystitis was reported by 20% of the cases and 8% of the controls, corresponding to a multivariate relative risk (RR) of 3.8 (95% confidence interval, 2.4 to 5.9). No association was observed with urinary tract stones (RR = 1.2). With reference to genital diseases, the RR was elevated for gonorrhea (RR = 2.8, 95% confidence interval, 1.0 to 4.5) and condylomata acuminata (RR = 5.9, 95% confidence interval 1.0 to 3.6) but not for syphilis. The risk increased with the number of episodes of cystitis (RR = 5.0 for 4 episodes, x² for trend = 33.04, P < 0.001), was higher during the last 15 years after the first episode (RR = 5.1 versus 2.3 for over 15 years), and was not heterogeneous across strata of age and sex. The interaction between urinary tract infections and tobacco appeared multiplicative, with RR = 2.4 for ever smoking, 3.2 for cystitis alone, and 10.3 for both exposures. The present study, besides providing further quantitative evidence of a relationship between urinary tract infections (and, possibly, some genital infections, too) and bladder cancer, indicates that the role of infections is probably in one of the latter (promoting) stages of the process of carcinogenesis and suggests a multiplicative interaction with smoking. In terms of prevention and public health, therefore, it is thus important to avoid at least one exposure for subjects with a history of urinary tract infections who smoke tobacco.

¹ This work was conducted within the framework of the National Research Council (CNR), Applied Projects "Oncology" (Contract 87.01544.44), and "Risk Factors for Disease," and with the contribution of the Italian Association for Cancer Research and the Italian League against Tumours, Milan.

² To whom requests for reprints should be addressed, at Istituto di Ricerche Farmacologiche "Mario Negri," Via Eritrea, 62, 20157 Milan, Italy.

Received 7/27/90. Accepted 10/29/90.

This article has been cited by other articles:

				M. A. Dominick, M. R. White, T. P. Sanderson, T. van Vleet, S. M. Cohen, L. E. Arnold, M. Cano, S. Tannehill-Gregg, J. D. Moehlenkamp, C. R. Waites, et al. Urothelial Carcinogenesis in the Urinary Bladder of Male Rats Treated with Muraglitazar, a PPAR{alpha}/{gamma} Agonist: Evidence for Urolithiasis as the Inciting Event in the Mode of Action Toxicol Pathol, December 1, 2006; 34(7): 903 - 920. [Abstract] [Full Text] [PDF]

				R.A. Crallan, N.T. Georgopoulos, and J. Southgate Experimental models of human bladder carcinogenesis Carcinogenesis, March 1, 2006; 27(3): 374 - 381. [Abstract] [Full Text] [PDF]

				M. McGrath, D. S. Michaud, and I. De Vivo Hormonal and Reproductive Factors and the Risk of Bladder Cancer in Women Am. J. Epidemiol., February 1, 2006; 163(3): 236 - 244. [Abstract] [Full Text] [PDF]

				L. S. Engel, E. Taioli, R. Pfeiffer, M. Garcia-Closas, P. M. Marcus, Q. Lan, P. Boffetta, P. Vineis, H. Autrup, D. A. Bell, et al. Pooled Analysis and Meta-analysis of Glutathione S-Transferase M1 and Bladder Cancer: A HuGE Review Am. J. Epidemiol., July 15, 2002; 156(2): 95 - 109. [Abstract] [Full Text] [PDF]

				T. Shirahama and C. Sakakura Overexpression of Cyclooxygenase-2 in Squamous Cell Carcinoma of the Urinary Bladder Clin. Cancer Res., March 1, 2001; 7(3): 558 - 561. [Abstract] [Full Text]

				M. H. Mostafa, S. A. Sheweita, and P. J. O'Connor Relationship between Schistosomiasis and Bladder Cancer Clin. Microbiol. Rev., January 1, 1999; 12(1): 97 - 111. [Abstract] [Full Text] [PDF]

				D.P. Mikhailidis, E.S. Ganotakis, J.A. Papadakis, and J.Y. Jeremy Smoking and urological disease The Journal of the Royal Society for the Promotion of Health, August 1, 1998; 118(4): 210 - 212. [Abstract]