World Journal of Urology

, Volume 25, Issue 3, pp 285–295

Epidemiology of urinary bladder cancer: from tumor development to patient’s death

  • Cristiane Murta-Nascimento
  • Bernd J. Schmitz-Dräger
  • Maurice  P. Zeegers
  • Gunnar Steineck
  • Manolis Kogevinas
  • Francisco X. Real
  • Núria Malats


Urinary bladder cancer (UBC) ranks ninth in worldwide cancer incidence. It is more frequent in men than in women. We review the main established/proposed factors, both environmental and genetic, associated with bladder cancer etiology and prognosis. Data were extracted from previous reviews and original articles identified from PubMed searches, reference lists, and book chapters dealing with the reviewed topics. Evaluation and consensus of both the contribution of each factor in bladder cancer burden and the appropriateness of the available evidences was done during an ad hoc meeting held during the 18th Congress of the European Society for Urological Research. Cigarette smoking and specific occupational exposures are the main known causes of UBC. Phenacetin, chlornaphazine and cyclophosphamide also increase the risk of bladder cancer. Chronic infection by Schistosoma haematobium is a cause of squamous cell carcinoma of the bladder. NAT2 slow acetylator and GSTM1 null genotypes are associated with an increased risk of this cancer. Vegetables and fresh fruits protect against this tumor. Regarding prognosis, there is little knowledge on the predictive role of environmental exposures and genetic polymorphisms on tumor recurrence and progression and patient’s death. Although active tobacco smoking is the most commonly studied factor, no definitive conclusion can be drawn from the literature. More research is needed regarding the effect of complex etiological factors in bladder carcinogenesis. Subgroup analysis according to stage, grade, and molecular features may help in identifying specific etiological and prognostic factors involved in different bladder cancer progression pathways.


Urinary bladder cancer Review Epidemiology Risk factors Prognosis Survival 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Cristiane Murta-Nascimento
    • 1
  • Bernd J. Schmitz-Dräger
    • 2
  • Maurice  P. Zeegers
    • 3
  • Gunnar Steineck
    • 4
  • Manolis Kogevinas
    • 1
  • Francisco X. Real
    • 1
    • 5
  • Núria Malats
    • 1
  1. 1.Centre de Recerca en Epidemiologia Ambiental (CREAL), Institut Municipal d’Investigació Medica (IMIM)BarcelonaSpain
  2. 2.Urologie, EuromedClinicFürthGermany
  3. 3.Unit of genetic epidemiology, Department of Public Health and Epidemiology, School of MedicineUniversity of BirminghamBirminghamUK
  4. 4.Division of Clinical Cancer EpidemiologyKarolinska InstitutetStockholmSweden
  5. 5.Universitat Pompeu FabraBarcelonaSpain

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