Distribution of smoking, water resource and other environmental factors in patients affected by superficial bladder cancer

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Abstract n. 1514 - A.U.A. 99th Annual Meeting of the American Urological Association. San Francisco, USA, 08-13/05/2004. The Journal of Urology, Vol. 171, No. 4, Supplement (2004)
Vincenzo Serretta, Vincenzo Altieri, Giuseppe Morgia, Rosalinda Allegro, Alessandra Di Lallo, Luca Cindolo, Darwin Melloni, Mario Motta, Francesco Paolo Selvaggi, Gianfranco Testa, Vincenzo Cosentino, D blendorio, Leonardo Borruso, Francesco Vacirca, Michele Pavone-Macaluso, Gruppo Uro-Oncologico Campano, And Gruppo Studi Tumori Urologici. University of Palermo, Palermo, Italy, University of Napoli, Napoli, Italy, University of Sassari, Sassari, Italy, Civivc Hospital of Campobasso, Campobasso, Italy, Civic Hospital, Benevento, Italy, University of Messina, Messina, Italy, University of Catania, Catania, Italy, University of Bari, Bari, Italy, Civic Hospital, Napoli, Italy, Civic Hospital, Gela (CL), Italy, Civic Hospital, Carbonara di bari (ba), Italy, Civivc Hospital, Salemi (TP), Italy, Civic Hospital, Caltanissetta, Italy, University of Napoli,
(guoc), Italy, GSTU, (gstu), Italy

Introduction and Objective: The pathogenetic role cancer of sigarette smoking and employment in bladder has been studied, however, that of other environmental factors is not well defined. Casecontrol studies require high numbers and are expensive. As a preliminary approach to larger casecontrol studies, the distribution of potential risk factors coming from environmental pollution among patients affected by superficial bladder cancer (TCCB) has been prospectively analized.

Methods: The analysis was limited to patients affected by medium risk superficial TCCB. Patients with primary single Ta G1-2, Tis or T1G3 tumors were excluded. All patients underwent TUR and early intravesical chemotherapy. Forty Italian urological centres joined the study. Detailed informations about age, sex, urban or extra-urban residency, employment, active and passive cigarette smoking, water resource, hair-dye use were centralized. The distribution of the above mentioned environmental factors was analyzed in relation to tumor characteristics such as multiplicity and previous natural history. Results: Until now today 474 patients have been recruited, 182 affected by primary tumors (38.4%) and 293 presenting multiple lesions (61.8%). Over 81% of the patients lived in urban areas, 88 patients (19%) were employed in industry and 36 (7.6%) used hair dye. Forty percent (196 patients) were smokers, with a median smoking period of 30 years.

One third have smoked cigarettes in the past. Bottled water was the only water resource for 192 patients (41%).At multivariate analysis a significant correlation between tumor multiplicity and employment in industry (p=0.01) and between past natural history and period of cigarette smoking (p=0.05) was found. Preliminarly, a correlation trend between water resource and bladder cancer in non-smoking patients was detected. For non-smokers the civic water system was the main water resource more frequently than for smokers (75% vs 53%). This might imply a role of water resource and chlorination as an enviromental risk factor. Conclusions: Industry employment and period of cigarette smoking were statistically related to multiplicity and previous history of the tumor. Water resource can be implied as an enviromental risk factor in non-smokers. Further and larger casecontrol studies are auspicable.

Acknowledgements We wish to thank all the members of the Gruppo Studio Tumori Urologici (GSTU). The study was supported in part by Ministero Italiano dell’Istruzione, Università e Ricerca (MIUR)

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