Abstract
The incidence of bladder cancer, and the importance of some selected risk factors in its etiology, were estimated from the data collected in the cancer registry of Bulawayo, Zimbabwe, during the period 1963–77. Cancer cases were interviewed with a standard questionnaire, and more than 70 percent of these were complete. Incidence rates in the urban population of Bulawayo in the first 10-year period were relatively high, with age standardized rates of 17.9 per 100,000 in men and 9.5 in women. Risk-factor distribution was compared in 680 bladder cancer cases (494 males, 186 females) and a control group comprising other cases with non-tobacco-related cancers (8,201). Seventy-one percent of bladder cancer cases were squamous cell carcinomas. The presence of schistosomiasis, evaluated from past history of bilharzia or hematuria, was associated with a significantly increased risk of bladder cancer in both genders (odds ratio [OR]=3.9 for men, 5.7 for women), a result reflected in the differing risk by province of residence, which correlated with the prevalence of infection among cancer cases. The proportion of bladder cancer attributable to schistosomiasis was estimated to be 28 percent. Social status, as reflected by education level, also influenced risk (ORs for literatecf illiterate males=0.6), but tobacco smoking in men had no effect on the risk of squamous cell tumors. For transitional cell carcinomas or adenocarcinomas, there was a nonsignificant increased risk of 2.0 in the highest smoking categories (15 g of tobacco per day), compared with non smokers.
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References
Oettlé AG. Cancer in Africa, especially in regions South of the Sahara.JNCI 1964;33: 383–439.
Cook PJ, Burkitt DP. Cancer in Africa.Brit Med Bull 1971;27: 14–20.
Cheever AW. Schistosomiasis and neoplasia.JNCI 1978;61: 13–8.
Pike MC.The Epidemiological Association between Schistosoma haematobiumInfection and Bladder Cancer. Geneva, Switzerland: World Health Organization, 1986.
Skinner MEG, Parkin DM, Vizcaino AP, Ndhlovu A.Cancer in the African Population of Bulawayo, Zimbabwe, 1963–1977. Lyon, France: International Agency for Research on Cancer, 1993; IARC Tech. Report No. 15.
Skinner MEG, Parker DA, Flegg MH, Fraser RW. Cancer incidence in Rhodesia, Bulawayo 1963–1967. In: Doll R, Muir C, Waterhouse J, eds.Cancer Incidence in Five Continents. Vol II Berlin, Germany: Springer-Verlag (for UICC), 1970: 94–7.
Skinner MEG, Parker DA, Chamisa C. Cancer incidence in Rhodesia, Bulawayo 1968–1972. In: Waterhouse J, Muir C, Correa P, Powell J, eds.Cancer Incidence in Five Continents. Vol III. Lyon, France: International Agency for Research on Cancer, 1976; IARC Sci. Pub. No. 15: 120–3.
Parkin DM, ed.Cancer Occurrence in Developing Countries. Lyon, France: International Agency for Research on Cancer, 1983; IARC Sci. Pub. No. 75: 125–30.
Breslow NE Day NE.Statistical Methods in Cancer Research Vol. I. The Analysis of Case-control Studies. Lyon, France: International Agency for Research on Cancer, 1980; IARC Sci. Pub. No 32.
Baker RJ, Nelder JA.Generalized Linear Interactive Modelling (GLIM) System, Release 3. Oxford, UK: Numerical Algorithms Group, 1978.
Young JL, Percy CL, Asire AJ, eds. Surveillance, Epidemiology and End Results: Incidence and Mortality data, 1973–77.NCI Monogr 1981; 57: 1–1082.
Houston W. Carcinoma of the bladder in Southern Rhodesia.Br J Urol 1964;36: 71–6.
Gelfand M, Weinberg RW, Castle WM. Relationship between carcinoma of the bladder and infestation with Schistosoma haematobium.Lancet 1967;i: 1249–51.
Thomas JE, Bassett MT, Sigola LB, Taylor P. Relationship between bladder cancer incidence, Schistosoma haematobium infection, and geographical region in Zimbabwe.Trans Roy Soc Trop Med Hyg 1990;84: 551–3.
Doumenge JP, Mott ME, Cheung C, et al, eds.Atlas of the Global Distribution of Schistosomiasis. Geneva, Switzerland: World Health Organization, 1987.
Mustacchi P, Shimkim MB. Cancer of the bladder and infestation with Schistosoma haematobium 1958.JNCI 1958;20: 825–41.
Elem B, Purohit R. Carcinoma of the urinary bladder in Zambia. A quantitative estimation of Schistosoma haematobium infection.Br J Urol 1983;55: 275–8.
Taylor P, Makura O. Prevalence and distribution of schistosomiasis in Zimbabwe.Ann Trop Med Parasitol 1985;79: 287–99.
Kantor AF, Hartge P, Hoover RN, Fraumeni JF Jr. Epidemiological characteristics of squamous cell carcinoma and adenocarcinomas of the bladder.Cancer Res 1988;48: 3853–5.
Logan WPD.Cancer Mortality by Occupation and Social Class 1851–1971 Lyon, France: International Agency for Research on Cancer, 1982 IARC: Sci. Pub. No. 36: 82–3.
La Vecchia C, Negri E, Franceschi S. Education and cancer risk.Cancer 1992;70: 2935–41.
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Vizcaino, A.P., Parkin, D.M., Boffetta, P. et al. Bladder cancer: epidemiology and risk factors in Bulawayo, Zimbabwe. Cancer Causes Control 5, 517–522 (1994). https://doi.org/10.1007/BF01831379
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DOI: https://doi.org/10.1007/BF01831379