Even though cigarette smoking accounts for up to half of all bladder cancer cases, few people are aware of the connection – including more than three-quarters of patients who have bladder cancer, according to a new study from the University of Michigan Comprehensive Cancer Center.

This knowledge vacuum suggests that urologists and other physicians need to do a much better job of telling patients about the risk of smoking and encourage them to quit, the study authors say.

“The general public understands that cigarette smoking can lead to lung cancer, but very few people understand that it also can lead to bladder cancer,” says senior author James E. Montie, M.D., Valassis Professor of Urologic Oncology at the U-M Health System.

Montie notes that in the first four years after a smoker quits, the risk of developing bladder cancer decreases by 40 percent. The study appears in the July issue of The Journal of Urology.

Most patients who already had bladder cancer were, like the general public, unaware of the link between smoking and bladder cancer, the authors say. They cite one study in which only 22 percent of patients with the disease were aware that smoking was a risk factor.

“A big gap exists between patient knowledge and their actual risk,” says lead author Seth A. Strope, M.D., MPH, clinical lecturer in the U-M Department of Urology. “Our study suggests that physicians must do a much better job of communicating the risk to our patients, and directing them toward smoking cessation programs.”

In the United States, more than 68,000 new cases of bladder cancer are expected to be diagnosed this year. Bladder cancer is one of the most costly cancers to treat, so the burden of the disease affects not only patients and their families but also the nation’s health care financing system.

Whites get bladder cancer twice as often as African Americans and Hispanics, and men are two to three times more likely than women to get bladder cancer, according to the National Cancer Institute. In addition to smoking, having a family history of the disease also can increase a person’s risk of developing bladder cancer. Secondhand smoke, the study notes, may be a risk factor but studies have not determined a conclusive link.

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Methodology: The researchers searched the MEDLINE database for studies from 1975 through 2007 that addressed the link between smoking and bladder cancer.

Funding: The research was supported by an NIH T32 Training Grant, with Montie as the principle investigator and Strope as the recipient.

Reference: The Journal of Urology, Vol. 180, 31-37, July 2008, “The causal role of cigarette smoking in bladder cancer initiation and progression, and the role of urologists in smoking cessation.”

Contact: Katie Vloet
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