Skip to main content

Advertisement

Log in

Lifestyle issues and genitourinary tumours

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

A variety of lifestyle factors, including physical activity, artificial sweeteners, alcohol consumption and smoking, have been reported to contribute to the risk of developing urological malignancies. A great number of epidemiological studies suggest that sports and physical activity may have a preventive influence on genitourinary tumours, especially on the incidence of prostate cancer. Smoking appears to be the most relevant lifestyle factor significantly increasing both incidence and mortality from bladder cancer. Furthermore, there is evidence implicating an association between tobacco use and kidney cancer. In contrast, prostate and testicular cancers are unlikely to be linked to tobacco use. As far as alcohol is concerned, most studies indicate that neither amount nor type of alcohol seems to be clearly associated with a risk of developing urological malignancies. However, some more recent cohort studies suggest a moderately increased risk for prostate and bladder cancer for specific types of alcohol. On the other hand, there is evidence that moderate alcohol consumption may even protect women from developing renal cancer. Since the introduction of artificial sweeteners, reports of potential cancer risks have circulated periodically through the mass media. The wide distribution of these agents and the fact that mostly combinations of the different compounds are added to a broad variety of food, drinks, drugs, and hygiene products complicates a systematic analysis of their potential impact on the development of urological malignancies. Nevertheless, so far not a single study has convincingly demonstrated a statistically significant risk of bladder cancer due to the consumption of artificial sweeteners. This survey demonstrates that the individual assessment of lifestyle factors not only may identify groups with an increased risk for urological malignancies but also clearly displays a potential for tumour prevention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1.
Fig. 2.
Fig. 3.

Similar content being viewed by others

References

  • Albertsen K, Gronbaek M (2002) Does amount or type of alcohol influence the risk of prostate cancer? Prostate 52:297–304

    Article  PubMed  Google Scholar 

  • Armstrong B, Doll R (1974) Bladder cancer mortality in England and Wales in relation to cigarette smoking and saccharin consumption. Br J Prev Soc Med 28:233–240

    CAS  PubMed  Google Scholar 

  • Armstrong B, Doll R (1975) Bladder cancer mortality in diabetics in relation to saccharin consumption and smoking habits. Br J Prev Soc Med 29:73–81

    CAS  PubMed  Google Scholar 

  • Bagnardi V, Blangiardo M, La Vecchia C, Corrao G (2001) A meta-analysis of alcohol drinking and cancer risk. Br J Cancer 85:1700–1705

    Article  CAS  PubMed  Google Scholar 

  • Becker N (2001) Epidemiologic aspects of cancer prevention in Germany. J Cancer Res Clin Oncol 127:9–19

    Article  CAS  PubMed  Google Scholar 

  • Bedwani R, el-Khwsky F, Renganatha E, et al (1997) Epidemiology of bladder cancer in Alexandria, Egypt: tobacco smoking. Int J Cancer 73:64–67

    Article  CAS  PubMed  Google Scholar 

  • Borden EC, Chin P (1994) Interleukin 6: A cytokine with potential diagnostic and therapeutic roles. J Lab Clin Med 123:824–829

    CAS  PubMed  Google Scholar 

  • Boyle P (1995) Tobacco and cancer, the European perspective. Ann Oncol 6:435–437

    CAS  PubMed  Google Scholar 

  • Brennan P, Bogillot O, Cordier S et al (2000) Cigarette smoking and bladder cancer in men: a pooled analysis of 11 case-control studies. Int J Cancer 86:289–294

    CAS  PubMed  Google Scholar 

  • Brennan P, Bogillot O, Greiser E et al (2001) The contribution of cigarete smoking to bladder cancer in women (pooled European data). Cancer Causes Control 12:411–417

    Article  CAS  PubMed  Google Scholar 

  • Bright G (1999) Low-calory sweeteners—from molecules to mass markets. World Rev Nutr Diet 85:3–9

    CAS  PubMed  Google Scholar 

  • Brown LM, Pottern LM, Hoover RN (1987) Testicular cancer in young men: the search for causes of the epidemic increase in the United States. J Epidemiol Community Health 41:349–354

    CAS  PubMed  Google Scholar 

  • Burch JD, Rohan TE, Howe GR et al (1989) Risk of bladder cancer by source and type of tobacco exposure: a case-control study. Int J Cancer 44:622–628

    CAS  PubMed  Google Scholar 

  • Byers T, Nestle M, McTiernan A, Doyle C, Currie-Williams A, Gansler T, Thun M (2002) American Cancer Society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 52:92–119

    PubMed  Google Scholar 

  • Castro GD, Delgado de Layno AM, Costantini MH, Castro JA (2001) Rat ventral prostate xanthine oxidase bioactivation of ethanol to acetaldehyde and 1-hydroxyethyl free radicals: analysis of its potential role in heavy alcohol drinking tumor-promoting effects. Teratog Carcinog Mutagen 21:109–119

    Article  CAS  PubMed  Google Scholar 

  • Clemmesen J (1997) Is pregnancy smoking causal to testis cancer in sons? A hypothesis. Acta Oncol 36:59–63

    CAS  PubMed  Google Scholar 

  • Cohen SM, Anderson TA, de Oliveira LM, et al (1998) Tumorigenicity of sodium ascorbate in male rats. Cancer Res 58:2557–2561

    CAS  PubMed  Google Scholar 

  • Colombo P, Scarpino V, Zuccaro P, et al (2002) Smoking in Italian women and men, 2001. Tumori 88:10–12

    PubMed  Google Scholar 

  • Davey SG, Shipley MJ, Batty GD, Morris JN, Marmot M (2000) Physical activity and cause-specific mortality in the Whitehall study. Public Health 114:308–315

    PubMed  Google Scholar 

  • Dhote R, Pellicer-Coeuret M, Thiounn N, Debre B, Vidal-Trecan G (2000) Risk factors for adult renal cell carcinoma: a systematic review and implications for prevention. BJU Int 86:20–27

    Article  CAS  PubMed  Google Scholar 

  • Dimeo F (2001) Körperliche Aktivität und Krebs: Eine Übersicht, Deutsche Zeitschrift für Sportmedizin 52:5–9

  • Doll R (1996) Cancers weakly related to smoking. Br Med Bull 52:35–49

    CAS  PubMed  Google Scholar 

  • Doll R (1999) The Pierre Denoix Memorial Lecture: nature and nurture in the control of cancer. Eur J Cancer 35:16–23

    Article  CAS  PubMed  Google Scholar 

  • Donato F, Boffetta P, Fazioli R, Aulenti V, Gelatti U, Porru S (1997) Bladder cancer, tobacco smoking, coffee and alcohol drinking in Brescia, northern Italy. Eur J Epidemiol 13:795–800

    Article  CAS  PubMed  Google Scholar 

  • FDA extends ban on cyclamates. (1970) Science 169:962

    PubMed  Google Scholar 

  • Fukushima S, Arai M, Nakanowatari J, et al (1983) Differences in susceptibility to sodium saccharin among various strains of rats and other animal species. Gann 74:8–20

    CAS  PubMed  Google Scholar 

  • Gaunt IF, Sharratt M, Grasso P, et al (1974) Short-term toxicity of cyclohexylamine hydrochloride in the rat. Food Cosmet Toxicol 12:609–624

    Article  CAS  PubMed  Google Scholar 

  • Geoffroy-Perez B, Cordier S (2001) Fluid consumption and the risk of bladder cancer: results of a multicenter case-control study. Int J Cancer 93:880–887

    Article  CAS  PubMed  Google Scholar 

  • Giovannucci E, Rimm EB, Ascherio A, et al (1999) Smoking and risk of fatal and fatal prostate cancer in United States health professionals. Cancer Epidemiol Biomakers Prev 8:277–282

    CAS  Google Scholar 

  • Hagiwara A, Fukushima S, Kitaori M, et al (1984) Effects of three sweeteners on rat urinary bladder carcinogenesis initiated by N-butyl-N-(4-hydroxybutyl)-nitrosamine. Gann 75:763–768

    CAS  PubMed  Google Scholar 

  • Henderson BE, Benton B, Jing J, YU MC, Pike MC (1979) Risk factors for cancer of the testis in young men. Int J Cancer 23:598–602

    PubMed  Google Scholar 

  • Hsieh TC, Wu JM (1999) Differential effects on growth, cell cycle arrest, and induction of apoptosis by resveratrol in human prostate cancer cell lines. Exp Cell Res 249:109–115

    CAS  PubMed  Google Scholar 

  • Hsing AW, McLaughlin JK, Schuman LM, et al (1990) Diet, tobacco use, and fatal prostate cancer: results from the Lutheran Brotherhood Cohort Study. Cancer Res 50:6836–6840

    CAS  PubMed  Google Scholar 

  • Hsing AW, McLaughlin JK, Hrubec Z, Blot WJ, Fraumeni JF (1991) Tobacco use and prostate cancer: 26-year follow-up of US veterans. Am J Epidemiol 133:437–441

    CAS  PubMed  Google Scholar 

  • International Agency for Research on Cancer (1986) Tobacco: a major international health hazard. IARC, Lyon

  • International Agency for Research on Cancer (2002) IARC monographs programme declares second-hand smoke carcinogenic to humans. http://www.iarc.fr/pageroot/PRELEASES/pr141a.html

  • Ishii H (1981) Incidence of brain tumors in rats fed aspartame. Toxicol Lett 7:433–437

    Article  CAS  PubMed  Google Scholar 

  • Jacobson MF, Farber E, Clapp R (1998) Re: Long-term feeding of sodium saccharin to nonhuman primates: implications for urinary tract cancer [letter; comment]. J Natl Cancer Inst 90:934–936

    Article  CAS  PubMed  Google Scholar 

  • Jeffrey AM, Williams GM (2000) Lack of DNA-damaging activity of five non-nutritive sweeteners in the rat hepatocyte/DNA repair assay. Food Chem Toxicol 38:335–338

    Article  CAS  PubMed  Google Scholar 

  • Jensen OM, Kamby C (1982) Intra-uterine exposure to saccharin and risk of bladder cancer in man. Int J Cancer 29:507–509

    CAS  PubMed  Google Scholar 

  • La Vecchia C, Franceschi S, Levi F (2003) Epidemiological research on cancer with a focus on Europe. Eur J Cancer Prev 12:5–14

    Article  PubMed  Google Scholar 

  • Levi F, La Vecchia C (2001) Tobacco smoking and prostate cancer: time for an appraisal. Ann Oncol 12:733–738

    Article  CAS  PubMed  Google Scholar 

  • Lindblad P, Wolk A, Bergstrom R, Adami HO (1997) Diet and risk of renal cell cancer: a population-based case-control study. Cancer Epidemiol Biomarkers Prev 6:215–223

    CAS  PubMed  Google Scholar 

  • Mac Kinnon LT (1992) Exercise and immunology. Human Kinetics Books, Champaign

  • McCredie M, Stewart JH (1992) Risk factors for kidney cancer in New South Wales: I. Cigarette smoking. Eur J Cancer 28A:2050–2054

    CAS  PubMed  Google Scholar 

  • McLaughlin JK, Lipworth L (2000) Epidemiologic aspects of renal cell cancer. Semin Oncol 27:115–123

    CAS  PubMed  Google Scholar 

  • McLaughlin JK, Hrubec Z, Heineman EF, et al (1990) Renal cancer and cigarette smoking: 26-year follow-up of U.S. veterans. Pub Health Rep 105:535–537

    CAS  Google Scholar 

  • McLaughlin JK, Silverman DT, Hsing AW, et al (1992) Cigarette smoking and cancers of the renal pelvis and ureter. Cancer Res 52:254–257

    CAS  PubMed  Google Scholar 

  • McLaughlin JK, Lindblad P, Mellemgaard A, et al (1995) International renal-cell cancer study. I. Tobacco use. Int J Cancer 60:194–198

    CAS  PubMed  Google Scholar 

  • McLaughlin JK, Blot WJ, Devesa SS, et al (1996) Renal cancer. In: Schoffenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and revention, 2nd edn. Oxford University Press, New York, pp 1142–1155

  • Mellemgaard A, Engholm G, McLaughin JK, Olsen JH (1994) Risk factors for renal cell carcinoma in Denmark. Cancer Causes Control 5:105–113

    CAS  PubMed  Google Scholar 

  • Morris GZ, Williams RL, Elliott MS, Beebe SJ (2002) Resveratrol induces apoptosis in LNCaP cells and requires hydroxyl groups to decrease viability in LNCaP and DU 145 cells. Prostate. 52:319–329

    Google Scholar 

  • Morrison AS, Buring JE (1980) Artificial sweeteners and cancer of the lower urinary tract. N Engl J Med 302:537–541

    CAS  PubMed  Google Scholar 

  • Neumann M, Bitton A, Glantz S (2002) Tobacco industry strategies for influencing European Community tobacco advertising legislation. Lancet 359:1323–1330

    Article  PubMed  Google Scholar 

  • Pelucchi C, Negri E, Franceschi S, Talamini R, La Vecchia C (2002) Alcohol drinking and bladder cancer. J Clin Epidemiol 55:637–641

    Article  PubMed  Google Scholar 

  • Peters C, Lotzerich H, Niemeier B, Schule K, Uhlenbruck G (1994) Influence of a moderate exercise training on natural killer cytotoxicity and personality traits in cancer patients. Anticancer Res 14(3A):1033–1036

    CAS  PubMed  Google Scholar 

  • Piper JM, Matanoski GM, Tonascia J (1986) Bladder cancer in young women. Am J Epidemiol 123:1033–1042

    CAS  PubMed  Google Scholar 

  • Pitard A, Brennan P, Clavel J, et al (2001) Cigar, pipe and cigarette smoking and bladder cancer risk in European men. Cancer Causes Control 12:551–556

    Article  CAS  PubMed  Google Scholar 

  • Renwick AG (1986) The metabolism of intense sweeteners. Xenobiotica 16:1057–1071

    CAS  PubMed  Google Scholar 

  • Roberts A, Renwick AG (1989) The pharmacokinetics and tissue concentrations of cyclohexylamine in rats and mice. Toxicol Appl Pharmacol 98:230–242

    CAS  PubMed  Google Scholar 

  • Roberts A, Renwick AG, Ford G, et al (1989) The metabolism and testicular toxicity of cyclohexylamine in rats and mice during chronic dietary administration. Toxicol Appl Pharmacol 98:216–229

    CAS  PubMed  Google Scholar 

  • Rodriguez C, Tatham LM, Thun MJ, Calle EE, Heath CW Jr (1997) Smoking and fatal prostate cancer in a large cohort of adult men. Am J Epidemiol 145:466–475

    CAS  PubMed  Google Scholar 

  • Ross RK, Paganini-Hill A, Landolph J, Gerkins V, Henderson BE (1989) Analgesics, cigarette smoking, and other risk factors for cancer of the renal pelvis and ureter. Cancer Res 49:1045–1048

    CAS  PubMed  Google Scholar 

  • Schuurman AG, Goldbohm RA, van den Brandt PA (1999) A prospective cohort study on consumption of alcoholic beverages in relation to prostate cancer incidence (The Netherlands). Cancer Causes Control 10:597–605

    Article  CAS  PubMed  Google Scholar 

  • Sesso HD, Paffenbarger RS Jr, Lee IM (2001) Alcohol consumption and risk of prostate cancer: The Harvard Alumni Health Study. Int J Epidemiol 30:749–755

    Article  CAS  PubMed  Google Scholar 

  • Shapiro JA, Jacobs EJ, Thun MJ (2000) Cigar smoking in men and risk of death from tobacco-relatec cancers. J Natl Cancer Inst 92:333–337

    Article  CAS  PubMed  Google Scholar 

  • Sharpe CR, Siemiatycki J (2001) Case-control study of alcohol consumption and prostate cancer risk in Montreal, Canada. Cancer Causes Control 12:589–598

    Article  CAS  PubMed  Google Scholar 

  • Silverman DT, Hartge P, Morrison AS, Devesa SS (1992) Epidemiology of bladder cancer. Hematol Oncol Clin North Am 6(1):1–30

    CAS  Google Scholar 

  • Simoes EJ, Byers T, Coates RJ, Serdula MK, Mokdad AH, Heath GW (1995) The association between leisure-time physical activity and dietary fat in American adults. Am J Public Health 85:240–244

    CAS  PubMed  Google Scholar 

  • Simon D, Yen S, Cole P (1975) Coffee drinking and cancer of the lower urinary tract. J Natl Cancer Inst 54:587–591

    CAS  PubMed  Google Scholar 

  • Sommer F, Peters HJ, Klotz T, Michna H, Schoenenberger A, Engelmann U (2002) Sport und Bewegung in der Prävention Urologischer Erkrankungen. Urologe B 42:297–305

    Google Scholar 

  • Squire RA (1985) Histopathological evaluation of rat urinary bladders from the IRDC two-generation bioassay of sodium saccharin. Food Chem Toxicol 23:491–497

    Article  CAS  PubMed  Google Scholar 

  • Statistisches Bundesamt [Federal Statistical Office Germany] (2001) Press Release from 25 October 2001

  • Sturgeon SR, Hartge P, Silverman DT, et al (1994) Associations between bladder cancer risk factors and tumor stage and grade at diagnosis. Epidemiology 5:218–225

    CAS  PubMed  Google Scholar 

  • Takayama S, Sieber SM, Adamson RH, et al (1998) Long-term feeding of sodium saccharin to nonhuman primates: implications for urinary tract cancer. J Natl Cancer Inst 90:19–25

    Article  CAS  PubMed  Google Scholar 

  • Takayama S, Renwick AG, Johansson SL, et al (2000) Long-term toxicity and carcinogenicity study of cyclamate in nonhuman primates. Toxicol Sci 53:33–39

    Article  CAS  PubMed  Google Scholar 

  • Taylor JM, Weinberger MA, Friedman L (1980) Chronic toxicity and carcinogenicity to the urinary bladder of sodium saccharin in the in utero-exposed rat. Toxicol Appl Pharmacol 54:57–75

    CAS  PubMed  Google Scholar 

  • Uhlenbruck G, Order U (1991) Can endurance sports stimulate immune mechanisms against cancer and metastasis? In J Sports Med 12[Suppl 1]: 63–68

  • Uhlenbruck G, Lötzerich H, Peters C, Ledvina I (1992) Sport als zusätzliche Therapiemöglichkeit in der Krebsnachsorg. In: Klippel KF (ed) Integrative Betreuung des chronisch kranken Krebspatienten. Kongressband vom V. Stuttgarter Immuntherapie-Symposium. Mack, Schönaich, pp 95–100

  • UK Testicular Cancer Study Group (1994) Social, behavioural and medical factors in the aetiology of testicular cancer: results from the UK study. Br J Cancer 70:513–520

    PubMed  Google Scholar 

  • US Environmental Protection Agency (1992) Respiratory health effects of passive smoking: lung cancer and other disorders. Environmental Protection Agency, Washington, DC

    Google Scholar 

  • Wannamethee SG, Shaper AG, Walker M (2001) Physical activity and risk of cancer in middle-aged men. Br J Cancer 85:1311–1316

    Article  CAS  PubMed  Google Scholar 

  • Weihrauch MR Diehl V, Bohlen H (2001) Künstliche Süßstoffe—Haben sie ein kanzerogenes Potential? Med Klin (Munich) 96:670–675

    Google Scholar 

  • Whysner J, Williams GM (1996) Saccharin mechanistic data and risk assessment: urine composition, enhanced cell proliferation, and tumor promotion. Pharmacol Ther 71:225–252

    Article  CAS  PubMed  Google Scholar 

  • Wynder EL, Goldsmith R (1977) The epidemiology of bladder cancer: a second look. Cancer 40:1246–1268

    CAS  PubMed  Google Scholar 

  • Wynder EL, Stellman SD (1980) Artificial sweeteners use and bladder cancer: a case-control study. Science 207:1214–1216

    CAS  PubMed  Google Scholar 

  • Yu H, Harris RE, Wynder EL (1988) Case-control study of prostate cancer and socioeconomic factors. Prostate 13:317–325

    CAS  PubMed  Google Scholar 

  • Yuan JM, Castelao JE, Cago-Dominguez M, et al (1998) Tobacco use in relation to renal cell carcinoma. Cancer Epidemiol Biomakers Prev 7:429–433

    CAS  Google Scholar 

  • Zeegers MP, Tan FE, Goldbohm RA, van den Brandt P (2001) Are coffee and tea consumption associated with urinary tract cancer risk? Int J Epidemiol 30:353–362

    Article  CAS  PubMed  Google Scholar 

  • Zeegers MP, Goldbohm RA, van den Brandt P (2002) A prospective study on active and environmental tobacco smoking and bladder cancer risk (The Netherlands). Cancer Causes Control 13:83–90

    PubMed  Google Scholar 

  • Zeegers MPA, Kellen E, Buntfix F, van den Brandt P (2004) The association between smoking, beverage consumption, diet and bladder cancer. World J Urol (in press)

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Frank Sommer.

Additional information

F.S., T.K. and B.S.D. are members of the CEM working circle on prevention, environment and complementary and alternative medicine of the German Society of Urology (DGU).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sommer, F., Klotz, T. & Schmitz-Dräger, B.J. Lifestyle issues and genitourinary tumours. World J Urol 21, 402–413 (2004). https://doi.org/10.1007/s00345-003-0379-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-003-0379-3

Keywords

Navigation