ASSESSMENT OF NONOCCUPATIONAL RISK-FACTOR S FOR TUMORS OF LOWER URINARY-TRACT - A CASE-CONTROL STUDY

Objective: A case-control study was performed to assess various nonocc upational factors (smoking, eating and drinking habits, intake of anal gesics) that may be aetiological factors in the development of tumours of the lower urinary tract, while vitamins may be protective. Patient s and methods: 150 patients (125 men, mean age 66.4 years; 25 women, m ean age 68.2 years) with histologically confirmed malignant tumour of bladder or other part of the lower urinary tract and a comparable grou p of controls, matched for age, sex and home location, were asked in a standardised personal interview about their life-long habits of smoki ng, eating and drinking, as well as intake of analgesics. Results: Smo king was the greatest risk factor. In men there was a significant posi tive dose-effect relationship between the number of cigarettes smoked a nd relative carcinoma risk, compared with nonsmokers, by a factor of 3.68 among those with the highest dosage (> 40 pack-years). Because o f the small number of cases this relationship could not be proven in w omen, but twice as many female tumour patients than controls were smok ers (8 vs 4). In men, even after adjusting for smoking, increased coff ee consumption increased the risk by a factor of 2 (2-4 cups: odds rat io 2.14 [P < 0.05]; > 5 cups: odds ratio 2.22 [not significant]). An i ncreased beer consumption had no apparent effect on the development of tumours. Findings regarding vitamin C were ambiguous. More prolonged and increased intake of phenacetin-containing analgesics in men showed a tendency towards a higher tumour risk. Conclusion: Smoking cigarett es is one of the main risk factors for the development of bladder and other lower urinary tract tumours. The influence of other risk factors needs to be elucidated.