[Bladder cancer and occupation: a descriptive analysis in Haute Normandie in 2003]

Haute Normandie is characterized by the presence of a large number of industries likely to have exposed their employees to a risk of bladder cancer. The objective of the study performed by Assurance Maladie (national health insurance) and Réseau d'Onco-Urologie de Haute Normandie (ROUHN) (Haute Normandie Urological Oncology Network) was to describe the epidemiological characteristics of bladder cancers and to estimate the proportion of potentially work-related cancers.

A questionnaire elaborated for the study and comprising demographic, clinical, environmental and occupational data was completed for all patients in whom exemption of co-payment for bladder cancer was requested in 2003.

The population comprised 258 patients with a mean age of 70.4 years. The sex-ratio was five males for one female. Tumours were diagnosed at an early stage: 73.9% of superficial tumours and 26.1% of invasive lesions. 72.1% of subjects were current smokers or ex-smokers (mean of 32 packet-years). Among the 41% of occupationally exposed subjects, 47.2% were mainly exposed to polycyclic aromatic hydrocarbons, 27.4% to diesel smoke and 17.9% to aromatic amines. Based on a multidisciplinary consultation, 14.7% of patients (n = 38) were considered to be eligible for an occupational disease declaration.

This study demonstrated that the incidence of occupational bladder cancers is underestimated. The urologist plays an essential role in the recognition of all risk factors of bladder cancer, as a history of smoking does not exclude the possibility of an occupational cause.