Are patients aware of the association between smoking and bladder cancer?

Smoking is the single greatest risk factor for bladder cancer. Since few studies have demonstrated the efficacy of screening for bladder cancer, primary prevention by decreasing the modifiable risk factors is the best defense. An aspect of modifying a behavioral risk factor is awareness of the association between behavior and disease. While many anti-smoking campaigns specifically focus on lung cancer, few mention bladder cancer. We evaluated the awareness of smoking as a risk factor for bladder cancer.

Between February and May 2005 we prospectively surveyed patients presenting to a urology clinic regarding their knowledge of risk factors for bladder cancer and other cancers. The questionnaire also captured data regarding patient smoking habits.

A total of 280 patients completed the survey, including 34% who were younger than 50 years, 63% who were male, 89% who were white and 57% who were college graduates. Only 36% vs 98% of the sample reported that smoking was a risk factor for bladder vs lung cancer. Patients with a higher level of education and females were statistically more likely to be aware of the association between smoking and bladder cancer.

Patients at a urology clinic had low overall knowledge regarding bladder cancer risk factors. Most patients queried had no idea regarding the relationship between bladder cancer and tobacco use regardless of smoking status. Our study suggests the need for the American public to be better educated to help combat smoking related cancers.