EPIDEMIOLOGY OF TRANSITIONAL-CELL CARCINOMA OF THE BLADDER - PROFILE OF AN URBAN-POPULATION IN THE SOUTHWEST OF ENGLAND

Objectives To produce an epidemiological profile of patients with tran sitional cell carcinoma (TCC) of the bladder living in the city of Bri stol (south-west England), to determine if TCC tumorigenesis is linked to possible risk factors (occupational exposure, cigarette smoking, a lcohol consumption and coffee consumption) and to assess phenotypic ac etylation status and thus determine whether there may be a genetic com ponent to tumour development. Patients and methods This cross-sectiona l observational epidemiological study recruited both cases and control s from one-stop haematuria clinics, providing two groups with a simila r age and sex distribution. Before diagnosis, all patients were interv iewed by the same researcher and results recorded on a specially desig ned database questionnaire, to eliminate both recall and investigator bias. Metabolic studies were also performed before diagnosis. Results There were significant associations for occupational exposure, cigaret te smoking, and beer consumption (but not wine or spirits), but no sig nificant association with coffee consumption, Slow acetylation status also conferred an increased risk. There were linear trends in terms of dose-response for both beer and cigarette consumption, although this was significant only for cigarettes, There was no difference in risk b etween the use of filtered or unfiltered cigarettes. Conclusion Occupa tional exposure and cigarette smoking have been well documented as ris k factors in the development of TCC of the bladder, as has slow acetyl ation status. There are very few studies linking bladder cancer with a lcohol consumption, It is important to subdivide types of alcohol cons umed when considering this factor in an epidemiological study. In the case of beer, methods used by different brewing processes may also con tribute to differences found, were such a study to be performed on a n ational scale.