RELATIVE IMPORTANCE OF RISK-FACTORS IN BLADDER CARCINOGENESIS - SOME NEW RESULTS ABOUT MEDITERRANEAN HABITS

In the Mediterranean region of France where bladder cancer mortality a nd incidence are high, a case-control study with 219 male incident cas es and 794 randomized, male population-controls was carried out in 198 7-89 to investigate bladder cancer risk factors and more specifically, regional factors. A stepwise logistic regression was applied to the d ata. This investigation confirms the role of tobacco and of certain oc cupational exposures in bladder carcinogenesis. There was a significan t dose-response relationship with lifelong coffee drinking and alcohol consumption; however the risk estimates were only significantly eleva ted for the heaviest drinkers. The intake of saccharin was not associa ted with risk of bladder cancer. Infrequent consumption of carrots, sp inach, and marrows conferred an increased risk, suggesting a protectiv e effect of vitamin A. Finally, this investigation results in some new hypotheses. The study of residences and birthplaces has revealed a lo wer risk for those who have lived in a non-Mediterranean area and a hi gher risk for those born in a Mediterranean area. These features might be explained by some Mediterranean dietary habits, such as a high con sumption of spices (odds ratio = 3.64, 95 percent confidence interval = 2.21-5.98).