• urinary bladder carcinoma;
  • postmenopausal women;
  • diabetes;
  • prospective study;
  • cigarette smoking



We evaluated prospectively the association of smoking and other potential risk factors with bladder carcinoma incidence in postmenopausal women.


A total of 37,459 women participating in the Iowa Women's Health Study completed baseline questionnaires in 1986 and were followed 13 years for bladder carcinoma incidence (n = 112).


Adjusted for potential confounders, the relative risk (RR) of bladder carcinoma in women who were current smokers compared with those who had never smoked was 3.58 (95% confidence interval [CI] = 1.86–6.88). The RR declined as years since quitting increased. Currently, married women, compared with unmarried women, had a RR of 0.66 (95% CI = 0.44–0.99). A 2.46-fold (95% CI = 1.32–4.59) increase in bladder carcinoma risk was identified for women who reported, versus did not report, diabetes. Regular versus no physical activity (RR = 0.66, 95% CI 0.43–1.01) and body mass index were inversely associated (P = 0.06) with bladder carcinoma incidence.


We confirmed that cigarette smoking is an important risk factor for bladder carcinoma in women; women who had quit smoking had a reduction of risk. We also identified diabetes as a potential risk factor, which may invite more research on its role in the development of urinary bladder carcinoma. Cancer 2002;95:2316–23. © 2002 American Cancer Society.

DOI 10.1002/cncr.10975