Certain Ecologic Factors Associated with Greater Risk of Bladder Cancer

Persons drinking well water (as opposed to public supply) may be at an increased risk of bladder cancer, according to new research from the University of Alabama at Birmingham. Researchers will present data about the relationship between bladder cancer and certain ecologic factors including water source and UV radiation levels at the 104th Annual Scientific Meeting of the American Urological Association (AUA).

From these results, researchers hypothesized that increased bladder cancer risks from well water may arise from pesticide contamination, which may be present in drinking water from unmonitored domestic wells. Researchers also identified solar UV radiation as the best predictor of bladder cancer incidence and mortality in men, and solar UV radiation and smoking as the best predictors of incidence and mortality in women.

Because bladder cancer rates vary among states in the United States, and the causes for these variations are largely uncertain, researchers sought to compare bladder cancer incidence and mortality rates in the country to ecological factors that may have an association. The study compared bladder cancer incidence and mortality rates for men and women in the United States to levels of former cigarette smoking, solar UV radiation and well water as a source of drinking, as opposed to public supply. Lack of health insurance and median family income were taken into account to adjust for access to healthcare and socioeconomic status.

Researchers obtained cigarette smoking levels and health insurance statuses from the Behavioral Risk Factor Surveillance System, an annual survey sponsored by the Center for Disease Control and Prevention (CDC) for health tracking; state-specific solar UV radiation levels from the National Oceanic and Atmospheric Administration (NOAA); well water usage among states from the U.S. Geological Survey; and family income from the U.S. Census Bureau.

The study reaffirmed that cigarette smoking is directly associated with bladder cancer incidence and mortality rates in men and women, and found that well water intake is directly associated with bladder cancer incidence in women and mortality rates in both sexes; and that exposure to solar UV radiation is inversely associated with bladder cancer incidence and mortality rates in both sexes.

“Cigarette smoking is a well-known risk factor associated with bladder cancer but sources such as the patient's water supply are coming to light as potential unmonitored risk factors,” said J. Brantley Thrasher, MD, an AUA spokesman.

NOTE TO REPORTERS: Experts are available to discuss these studies outside normal briefing times.

Colli, J; Knox, M; Clayton, D; Martin, B; Waits, J; Amling, C. Bladder cancer incidence and mortality rates compared to ecologic factors in the United States. J Urol, suppl. 2009: 181, 4, abstract 460.

About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is the pre-eminent professional organization for urologists, with more than 16,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the highest standards of urologic care by carrying out a wide variety of programs for members and their patients.