[Etiology, pathogenesis and epidemiology or urothelial tumors]

A hospital-based case-control study of 531 male and 144 female matched pairs was conducted to analyse the role of nonoccupational and occupational risk factors in the etiology of tumors of the lower urinary tract. Smoking of cigarettes was associated with an increased risk and showed a significant dose- and time-response for both sexes. Heavy pipe smoking also significantly increased the risk. Controlling for smoking, a significantly twofold or more increase in risk was found for heavy consumption of coffee in both sexes and for heavy intake of beer in males. Increasing levels of total fluid intake were associated with increasing, smoking-adjusted risks in men. Significant associations were found for chronic infection of the lower urinary tract, familial history of bladder cancer, and frequent consumption of high fat meals among men and for frequent consumption of canned food in both sexes. With regard to occupational history, significantly elevated risks were found for ever-employment in the printing, plastics and synthetics, rubber, mining and dyestuffs industries, for exposure to spray paints, zinc, chromium/chromate, oils, petroleum and metal dust/fume, and for occupation as mining worker and truck driver among men. Multivariate logistic regression analysis showed-with the exception of fluid intake-significant contribution of the above-mentioned risks factors to the risk of bladder cancer.