Tobacco smoking, coffee drinking, and occupation as risk factors for bladder cancer in Greece

Patients with bladder cancer (250 males and 50 females), consecutively admitted during a 2-year period in the major cancer hospital of Athens, and an equal number of age- and gender-matched comparison patients with orthopedic conditions were interviewed regarding demographic, socioeconomic, and biomedical characteristics, including their occupations and their use of coffee and tobacco prior to the onset of their present disease or condition. Analyses of the data showed that cigarette smoking is an important, statistically significant and dose-dependent risk factor for bladder cancer, particularly in males (tobacco smoking is rare among older Greek women); drinking 2 or more cups of Greek coffee per day appears to be a risk factor for bladder cancer, independent of tobacco smoking, although the association is neither strong nor dose dependent; and a priori specified "high-risk" occupations were associated with an increased rate ratio for bladder cancer among men less than 65 years and among women in general but not among older men. The overall results of this study indicate that the established risk factors for bladder cancer in the United States and in other developed countries are, apparently, equally important for bladder cancer in Greece, despite the differences in composition and conditions of use of Oriental tobacco and Greek coffee and in the activities and exposures to carcinogens in the Greek work place.