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The purpose of the present study was to investigate the association between smoking and the development of bladder cancer. The study population consisted of 429,906 persons participating in the European Prospective Investigation into Cancer and Nutrition (EPIC), 633 of whom developed bladder cancer during the follow-up period. An increased risk of bladder cancer was found for both current- (incidence rate ratio 3.96, 95% confidence interval: 3.07-5.09) and ex- (2.25, 1.74-2.91) smokers, compared to never-smokers. A positive association with intensity (per 5 cigarettes) was found among current-smokers (1.18, 1.09-1.28). Associations (per 5 years) were observed for duration (1.14, 1.08-1.21), later age at start (0.75, 0.66-0.85) and longer time since quitting (0.92, 0.86-0.98). Exposure to environmental tobacco smoke (ETS) during childhood increased the risk of bladder cancer (1.38, 1.00-1.90), whereas for ETS exposure as adult no effect was detected. The present study confirms the strong association between smoking and bladder cancer. The indication of a higher risk of bladder cancer for those who start smoking at a young age and for those exposed to ETS during childhood adds to the body of evidence suggesting that children are more sensitive to carcinogens than adults.

Original publication

DOI

10.1002/ijc.22169

Type

Journal article

Journal

International journal of cancer

Publication Date

11/2006

Volume

119

Pages

2412 - 2416

Addresses

Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.

Keywords

Humans, Incidence, Proportional Hazards Models, Odds Ratio, Risk Factors, Prospective Studies, Smoking, Tobacco Smoke Pollution, Age Factors, Time Factors, Adolescent, Adult, Aged, Middle Aged, Europe, Female, Male, Urinary Bladder Neoplasms, Nutritional Physiological Phenomena