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Harnblasenkarzinom

Ursachen und Möglichkeiten der Vermeidung

The causes of urinary bladder cancer and possibilities of prevention

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Zusammenfassung

Das Harnblasenkarzinom zählt zu den malignen Tumoren, bei denen exogene und damit vermeidbare Einflüsse als ursächlich belegt sind. Zigarettenrauchen ist der mit Abstand wichtigste Risikofaktor, wobei das Erkrankungsrisiko mit dem Ausmaß des Zigarettenkonsums ansteigt. Bemerkenswert ist, dass sich das erhöhte Harnblasenkarzinomrisiko bereits wenige Jahre nach Beendigung des Rauchens wieder verringert. Zweiter wichtiger Risikofaktor sind berufliche Expositionen v. a. gegenüber krebserzeugenden aromatischen Aminen wie Benzidin und β-Naphthylamin sowie bestimmten Azofarbstoffen. Gefährdet sind v. a. Beschäftigte bei der Herstellung dieser Stoffe und — wenn auch deutlich geringer — Personengruppen, die diese Stoffe verarbeiten. Risiken durch umweltbedingte Expositionen scheinen, soweit bisher bekannt, eine geringere Rolle zu spielen. Therapiebedingte Risiken, die zum Harnblasenkarzinom als Zweitmalignom führen, sind zu beachten. Die Prävention besteht gegenwärtig v. a. in der Expositionsvermeidung und in der Früherkennung von Harnblasenkarzinomen bei Hochrisikokollektiven.

Abstract

Bladder cancer is a malignant disease with exogenous and thus avoidable causative factors. Cigarette smoking is by far the most relevant risk factor and a clear dose-response relationship has been documented. That the bladder cancer risk decreases only a few years after the cessation of smoking is noteworthy. Occupational exposure, particularly to aromatic amines such as benzidine and β-naphthylamine and to certain azo dyes, represents another important risk factor. At high risk are workers involved in the production of these chemicals and, to a lesser extent, those processing them. The currently known environmental factors seem to play a minor role. Treatment-induced risks causing secondary bladder cancer also have to be considered. Currently, the prevention of bladder cancer mainly involves avoiding exposure to known causative factors and early detection of the disease in high risk populations.

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  1. Urologische Klinik und Poliklinik, Universitätsklinikum Essen

    P. J. Goebell

  2. Institut für Hygiene und Arbeitsmedizin, Universitätsklinikum Essen

    A. W. Rettenmeier

  3. Institut für Arbeitsphysiologie an der Universität Dortmund, Ardeystraße 67, 44139 , Dortmund

    K. Golka

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Golka, K., Rettenmeier, A.W. & Goebell, P.J. Harnblasenkarzinom. Urologe 45, 361–368 (2006). https://doi.org/10.1007/s00120-006-1018-6

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