Total and specific fluid consumption as determinants of bladder cancer risk

• Published in: International journal of cancer Vol. 118; no. 8; pp. 2040 - 2047
• Main Authors: Villanueva, Cristina M., Cantor, Kenneth P., King, Will D., Jaakkola, Jouni J.K., Cordier, Sylvaine, Lynch, Charles F., Porru, Stefano, Kogevinas, Manolis
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.04.2006; Wiley-Liss; Wiley
• Subjects: Age Factors; Aged; Biological and medical sciences; bladder cancer; Cancer; Carcinogens; Case-Control Studies; case‐control study; Drinking Behavior; Female; fluid consumption; Humans; Life Sciences; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Odds Ratio; pooled analysis; Risk Factors; Sex Factors; tap water; Tumors; Tumors of the urinary system; Urinary Bladder Neoplasms; Urinary Bladder Neoplasms - epidemiology; Urinary Bladder Neoplasms - etiology; Urinary tract. Prostate gland; Water Supply; Human; Urinary system disease; Fluid; Trihalomethane; fluid consumption; Malignant tumor; Urinary tract disease; Case control study; Tap water; Bladder cancer; Epidemiology; Carcinogen; pooled analysis; Cancerology; case-control study; Risk factor; Bladder disease; Disinfecting agent; By product; Public health; bladder cancer; tap water
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.21587

We pooled the data from 6 case‐control studies of bladder cancer with detailed information on fluid intake and water pollutants, particularly trihalomethanes (THM), and evaluated the bladder cancer risk associated with total and specific fluid consumption. The analysis included 2,729 cases and 5,150 controls. Odds ratios (OR) and 95% confidence intervals (CI) for fluid consumption were adjusted for age, gender, study, smoking status, occupation and education. Total fluid intake was associated with an increased risk of bladder cancer in men. The adjusted OR for 1 l/day increase in intake was 1.08, (95% CI 1.03–1.14, p‐value for linear trend <0.001), while no trend was observed in women (OR = 1.04, 0.94–1.15; p‐value = 0.7). OR was 1.33 (1.12–1.58) for men in the highest category of intake (>3.5 l/day) as compared to those in the lowest (≤2 l/day). An increased risk was associated with intake of tap water. OR for >2 l/day vs. ≤0.5 l/day was 1.46 (1.20–1.78), with a higher risk among men (OR = 1.50, 1.21–1.88). No increased risk was observed for the same intake groups of nontap water in men (OR = 0.97, 0.77–1.22) or in women (OR = 0.85, 0.50–1.42). Increased bladder cancer risks were observed for an intake of >5 cups of coffee daily vs. <5 and for THM exposure, but neither exposure confounded or modified the OR for tap water intake. The association of bladder cancer with tap water consumption, but not with nontap water fluids, suggests that carcinogenic chemicals in tap water may explain the increased risk. © 2005 Wiley‐Liss, Inc.