Analysis of known risk factors for bladder cancer in Pakistani population

The association of aetiological agents incriminated for bladder cancer are well recognised. They are divided into two groups, occupational and non-occupational. The commonest occupational agents are 2-naphthylamine, benzidine, aminobiphenyl, dichlorobenzidine, orthodianisidine and orthotolidine. Recognised non-occupational agents include tobacco, recurrent chronic bladder infection/infestation, coffee and drugs. This study was conducted to evaluate these factors in patients with bladder cancer in our population. Of 250 cases studied, 203 were males and 47 females with a male to female ratio of 4.3:1. In 13.6% cases occupational factors were established with an average duration of exposure of 12 years. Majority (68%) of patients had smoking as the predominant non-occupational factor. In this group average cigarettes smoked per day was 23 with a range of 15 to 90. The duration of smoking ranged between 5 to 55 years with an average of 26 years. Sixty patients (24%) were neither smokers nor had any associated high risk occupation.