Abstract
Trends in mortality rates for bladder cancer in developed areas of the world are declining. This reflects the pattern of exposure of subsequent generations of men to tobacco smoking and aromatic amines, the two main recognized risk factors for bladder cancer. Infection with Schistosoma haematobium is another cause of bladder neoplasms, and suspected etiological factors include various occupational exposures, low consumption of vegetables and fruit, other urinary tract infections, and drinking water contaminated with arsenic. With reference to genetic factors, N-acetyltransferase-2 slow-acetylation status is associated with a modest increase in risk, and first-degree relatives of bladder cancer cases have a twofold risk of developing bladder cancer. Prevention of bladder cancer is feasible, through avoidance of tobacco smoking, close surveillance of occupational exposures to aromatic amines and other chemical agents, and control of bladder and other urinary tract infections and infestations. Efficient implementation of these strategies could considerably reduce the incidence of bladder cancer worldwide.
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