Cancer Causes & Control

, Volume 8, Issue 4, pp 560–567 | Cite as

Trends in urinary bladder cancer incidence in Sweden 1960-93 with special reference to histopathology, time period, birth cohort, and smoking

  • Magnus Thörn
  • Reinhold Bergström
  • Anna-Maria Johansson
  • Lars Ramström
  • Ingemar Persson
  • Per-Uno Malmström
Article

Abstract

This study investigates the incidence trends of urinary bladdercancer in Sweden from 1960 through 1993 (a total of 46,211 cases).Age-standardized incidence rates increased among men from 14.6 per 10 5 in1960 to 33.5 in 1993 and among women from4.8 to 8.8, corresponding to anaverage annual increase of 2.4 percent (95 percent confidence interval [CI])= 2.0-2.7 percent) and 1.1 percent (CI = 0.9-1.4 percent), respectively. Thelargest increase occurred in the oldest age-groups. The proportion ofpatients with transitional cell carcinoma increased in menfrom66.0 percent in1960-64 to 93.6 percent in 1990-93 and in women from 61.0 percent to 89.4percent. The proportion of patients with papillomas decreased, whereas thosewith adenocarcinoma and squamous cell carcinoma were stable. Regressionmodeling (based on the period 1960-89) showed a strong linear effect due toeither period and/or cohort. Among men, additional non-linear effects by bothperiod and cohort were obtained. T he cohort effects were more important.Cohort data on having smoked daily showed considerable similarities with theestimated cohort-effects. Our findings suggest that the increase of tobaccosmoking in successive generations can explain the increase in incidence ratesof bladder cancer in Sweden, whereas improved diagnostic activities andregistration are less likely to explain fully the changes in incidence rates.

Age factors bladder cancer cohort effect smoking Sweden 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Muir C, Waterhouse J, Mack T, Powell J, Whelan S, eds. Cancer Incidence in Five Continents, Vol. V. Lyon, France: International Agency for Research on Cancer, 1987.Google Scholar
  2. 2.
    Skov T, Sprøgel P, Engholm G, Frøland C. Cancer of the lung and urinary bladder in Denmark, 1943-87: a cohort analysis. Cancer Causes Control {dy1991}; 2: 365–9.Google Scholar
  3. 3.
    Jewett MAS, Periera G, Nijmeh P, et al. Increasing incidence, but stable mortality of bladder cancer in Ontario. Urology {dy1991}; 37: 4–6.Google Scholar
  4. 4.
    Kiemeney LALM, Coebergh JWW, Koper NP, et al. Bladder cancer incidence and survival in the south-eastern part of the Netherlands, 1975-1989. Eur J Cancer {dy1994}; 30A: 1134–7.Google Scholar
  5. 5.
    Cohen SM, Johansson SL. Epidemiology and etiology of bladder cancer. Urol Clin North Am {dy1992}; 3: 421–8.Google Scholar
  6. 6.
    The Cancer Registry. Cancer Incidence in Sweden 1960-1993. Stockholm, Sweden: National Board of Health and Welfare, 1961–96.Google Scholar
  7. 7.
    World Health Organization. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Seventh Revision. Geneva, Switzerland: World Health Organization, 1957.Google Scholar
  8. 8.
    Fleiss JL. The standardization of rates. In: Fleiss JL, ed. Statistical Methods for Rates and Proportions. New York, NY (USA): John Wiley and Sons, 1981: 237–55.Google Scholar
  9. 9.
    Baker RJ, Nelder JA. Generalised Linear Interactive Modelling (Release 3).Oxford, UK: Numerical Algorithms Group, 1978.Google Scholar
  10. 10.
    Clayton D, Schifflers E. Models for temporal variation in cancer rates. I. Age-period and age-cohort models. Stat Med {dy1987}; 6: 449–67.Google Scholar
  11. 11.
    Clayton D, Schifflers E. Models for temporal variation in cancer rates. II. The age-period-cohort model. Stat Med {dy1987}; 6: 469–81.Google Scholar
  12. 12.
    Mattsson B, Wallgren A. Completeness of the Swedish Cancer Registry. Non-notified cancer cases recorded on death certificates in 1978. Acta Radiol Oncol {dy1984}; 23: 305–13.Google Scholar
  13. 13.
    Malmström PU, Thörn M, Lindblad P, Bergström R, Adami HO. Increasing survival of patients with urinary bladder cancer. A nationwide study in Sweden 1960-1986. Eur J Cancer {dy1993}; 29A: 1868–72.Google Scholar
  14. 14.
    La Vecchia C, Lucchini F, Negri E, Boyle P, Maisonneuve P, Levi F. Trends of cancer mortality in Europe, 1955-1989: IV. Urinary tract, eye, brain and nerves, and thyroid. Eur J Cancer {dy1992}; 28A: 1210–81.Google Scholar
  15. 15.
    Mostofi FK, Sobin LH, Torloni H. Histological Typing of Urinary Bladder Tumours. Geneva, Switzerland: World Health Organization, 1973; International Histological Classification of Tumours, No. 10.Google Scholar
  16. 16.
    Cederlöf R, Friberg L, Hrubec Z, Lorich U. The Relationship of Smoking and Some Social Covariables to Mortality and Cancer Morbidity. A Ten Year Follow-up in a Probability Sample of 55,000 Subjects, Age 18-69, Part 1 and 2. Stockholm, Sweden: Department of Environmental Hygiene, The Karolinska Institute, 1975.Google Scholar
  17. 17.
    Cole P, Monson RR, Haning H, Friedell GH. Smoking and cancer of the lower urinary tract. N Engl J Med {dy1971}; 284: 129–34.Google Scholar
  18. 18.
    Miller AB. The etiology of bladder cancer from the epidemiologic viewpoint. Cancer Res {dy1977}; 37: 2939–42.Google Scholar
  19. 19.
    Howe GR, Burch JD, Miller AB, et al. Tobacco use, occupation, coffee, various nutrients and bladder cancer. JNCI {dy1980}; 64: 701–13.Google Scholar
  20. 20.
    Claude JC, Kunze E, Frentzel-Beyme R, Paczkowski K, Schneider J, Schubert H. Life-style and occupational risk factors in cancer of the lower urinary tract. Am J Epidemiol 1986; 124: 578–89.Google Scholar
  21. 21.
    Nomura A, Kolonel LN, Yoshizawa CN. Smoking, alcohol, occupation, and hair dye use in cancer of the lower urinary tract. Am J Epidemiol {dy1989}; 130: 1159–63.Google Scholar
  22. 22.
    Burns PB, Swanson GM. Risk of urinary bladder cancer among Blacks and Whites: the role of cigarette use and occupation. Cancer Causes Control {dy1991}; 2: 371–9.Google Scholar
  23. 23.
    Doll R, Peto R. The Causes of Cancer. Oxford,UK: Oxford University Press, 1981:1220–4.Google Scholar
  24. 24.
    Jensen OM, Wahrendorf, Blettner M, Knudsen JB, Sørensen BL. The Copenhagen case-control study of bladder cancer: role of smoking in invasive and non-invasive bladder tumours. J Epidemiol Common Health {dy1987}; 41: 30–6.Google Scholar
  25. 25.
    Sorahan T, Lancashire R, Sole G. Urothelial cancer and cigarette smoking: findings from a regional case-controlled study. Br J Urol {dy1994}; 74: 753–6.Google Scholar
  26. 26.
    Clemmensen J. Statistical studies in the aetiology of malignant neoplasms. Acta Pathol Microbiol Scand {dy1974}; Suppl 247: 54–63.Google Scholar
  27. 27.
    Matanoski GM, Elliott EA. Bladder cancer epidemiology. Epidemiol Rev {dy1981}; 3: 203–29.Google Scholar
  28. 28.
    Doll R, Peto R. The causes of cancer: quantitative estimates of avoidable risk of cancer in the United States today. JNCI 1981; 66: 1193–265.Google Scholar
  29. 29.
    Ross RK, Jones PA, Yu MC. Bladder cancer epidemiology and pathogenesis. Semin Oncol {dy1995}; 23: 536–45.Google Scholar
  30. 30.
    Steineck G, Hagman U, Gerhardsson M, Norell SE. Vitamin A supplements, fried foods, fat and urothelial cancer. A case-referent study in Stockholm in 1985-87. Int J Cancer 1990; 45: 1006–11.Google Scholar
  31. 31.
    Steineck G, Plato N, Gerhardsson M, Norell SE, Hogstedt C. Increased risk of urothelial cancer in Stockholm during 1985-87 after exposure to benzene and exhausts. Int J Cancer 1990; 45: 1012–7.Google Scholar

Copyright information

© Chapman and Hall 1997

Authors and Affiliations

  • Magnus Thörn
    • 1
    • 2
  • Reinhold Bergström
    • 1
    • 3
  • Anna-Maria Johansson
    • 1
  • Lars Ramström
    • 1
    • 4
  • Ingemar Persson
    • 1
  • Per-Uno Malmström
    • 1
    • 5
  1. 1.Department of Cancer EpidemiologyUniversity HospitalUppsalaSweden
  2. 2.Department of SurgeryUppsala UniversityUppsalaSweden
  3. 3.Department of StatisticsUppsala UniversityUppsalaSweden
  4. 4.Institute for Tobacco StudiesStockholmSweden
  5. 5.Department of UrologyUniversity HospitalUppsalaSweden

Personalised recommendations