Histologic changes in the urinary bladder in relation to cigarette smoking and use of artificial sweeteners

A total of 6503 sections of urinary bladder epithelium from 282 subjects were examined in random order, and histologic alterations, particularly the number of cell rows and the presence and extent of cells with atypical nuclei, were recorded. Cases were either individuals who had never smoked or who had smoked cigarettes. Microscopic slides with cells having 50% or more atypical nuclei were found in 4.3% of those who had never smoked; 67.1% in those who had smoked less than 20 cigarettes a day; 82.3% in those who had smoked 20 to 39 cigarettes a day; and 88.4% of the 40 or more a day cigarette smokers. The percentage of slides with six or more cell rows in these groups were 4.8%, 52.2%, 62.5%, and 72.9%, respectively. The histologic findings in the urinary bladder in relation to smoking habits fully complement the epidemiologic studies showing a dose-response of cigarette smoking and urinary bladder cancer. No relationship was found between changes in the urinary bladder epithelium and the use of artificial sweeteners.