Etiopathology, risk factors, environmental influences and epidemiology of bladder cancer

The etiology of bladder cancer is well investigated. Bladder carcinogenicit y of nitrosamines is proven in animals but not in men, although dimethylnit rosamine in urine of patients with urinary infections or bilharziosis sugge st a causative role. Aromatic amines are strong bladder carcinogens. Arsen is proven to be bladder carcinogenic as well as the nitrofurane FANFT. Nitr ofurantoin however is not bladder carcinogenic nor are the endogenous metab olites of tryptophan. The influence of papilloma virus on bladder carcinoma induction ist not def initely proven yet. Bilharziosis or chronic urinary infections correlate wi th bladder carcinomas, nitrosamines being the possible reason. The reason f or the increased incidence of bladder cardinoma in balkan nephropathy ist n ot clear. Arcolein as a metabolite of Cyclophosphamid is a strong bladder c arcinogen as well as Phenacetin. Immune supression and radiotherapy are ris k factors, too. About 50% of bladder carcinomas are due to cigaret smoking.