The influence of environmental risk factors on the development of bladder cancer

Abstract

Every year the number of bladder cancer (UBC) cases is increasing. Global Analysis in 2009 registered 2.7 million diagnosed patients. Due to rising rates of morbidity and high costs of treatment, it is very important to identify risk factors for UBC and prevent at risk persons from further exposure. Environmental factors that have the proven strongest impact on the development of UBC include: smoking, aromatic amines, polycyclic aromatic hydrocarbons, nitrosamines, arsenic and cadmium. Experimental studies indicate carcinogenic effects of some urea-derived pesticides and organochloride pesticides on the uroepithelium. An important role is also played by inflammation, Schistosoma haematobium infections, exposure to ionizing radiation and immunosuppressive therapy. However, when exposure to second-hand smoking is considered, water disinfection byproducts, halogenated hydrocarbons, nitrites and nitrates, further studies are needed in order to clarify their role in the development of UBC. The relationship between environmental exposure and the morbidity rate is more pronounced in bladder cancer than in other cancers. Interaction between environmental factors and genetic susceptibility seems to be the most important risk factor. This was proven by studies of genotype of GST, NAT and other detoxifying enzymes genotypes. Genetic predisposition plays an important role and therefore prevention strategy should include determining such risk groups. This paper presents the current state of knowledge of the effects of environmental risk factors on the development of bladder cancer.