Total and specific fluid consumption as determinants of bladder cancer risk

Authors

  • Cristina M. Villanueva,

    Corresponding author
    1. Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
    • Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Doctor Aiguader, 80, 08003-Barcelona, Spain

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  • Kenneth P. Cantor,

    1. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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  • Will D. King,

    1. Department of Community Health and Epidemiology, Queen's University, Ontario, Canada
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  • Jouni J.K. Jaakkola,

    1. Department of Public Health, University of Helsinki, Finland
    2. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, United Kingdom
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  • Sylvaine Cordier,

    1. INSERM U625, Université de Rennes I, Rennes, France
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  • Charles F. Lynch,

    1. Department of Epidemiology, University of Iowa, Iowa City, IA, USA
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  • Stefano Porru,

    1. Institute of Occupational Health, University of Brescia, Brescia, Italy
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  • Manolis Kogevinas

    1. Respiratory and Environmental Health Research Unit, Institut Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
    2. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Abstract

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.

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