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Risk Factors Involved in the High Incidence of Bladder Cancer in an Industrialized Area in North-Eastern Spain: A Case-Control Study. J Clin Med 2023; 12:jcm12020728. [PMID: 36675657 PMCID: PMC9867509 DOI: 10.3390/jcm12020728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Bladder cancer (BC) is the most common of the malignancies affecting the urinary tract. Smoking and exposure to occupational and environmental carcinogens are responsible for most cases. Vallès Occidental is a highly industrialized area in north-eastern Spain with one of the highest incidences of BC in men. We carried out a case-control study in order to identify the specific risk factors involved in this area. Three hundred and six participants were included (153 cases BC and 153 controls matched for age and sex): in each group, 89.5% (n = 137) were male and the mean age was 71 years (range 30-91; SD = 10.6). There were no differences between groups in family history, body mass index, or dietary habits. Independent risk factors for CV were smoking (OR 2.08; 95% CI 1.30-3.32; p = 0.002), the use of analgesics in nonsmokers (OR 10.00; 95% CI 1.28-78.12; p = 0.028), and profession (OR: 8.63; 95% CI 1.04-71.94; p = 0.046). The consumption of black and blond tobacco, the use of analgesics in nonsmokers, and occupational exposures are risk factors for the development of BC in this area, despite the reduction in smoking in the population and the extensive measures taken in the last few decades in major industries to prevent exposure to occupational carcinogens.
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Environmental Factors Involved in the High Incidence of Bladder Cancer in an Industrialized Area in North-Eastern Spain. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:1051046. [PMID: 35844948 PMCID: PMC9282998 DOI: 10.1155/2022/1051046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 02/08/2023]
Abstract
Background Bladder cancer (BC) is the most common of those affecting the urinary tract, and a significant proportion of the cases are attributable to tobacco use as well as occupational and environmental factors. Objective The aim of this study is to estimate the current incidence of BC in an industrialized area in northeastern Spain and to analyze its time trends over three decades from an ecological perspective. Methods Patients diagnosed with histologically confirmed primary BC, during 2018-2019, in an area in northeastern Spain (430,883 inhabitants) were included. Crude and age-standardized incidence rates were estimated per 100,000 person-years based on the number of individuals getting their first diagnosis. An exploratory time trend analysis was carried out to describe the evolution in tobacco use and occupational or environmental risk factors and the incidence of BC in the same area from the 1990s. Results 295 patients were included (age 72.5 ± 10.3 years; 89.8% men). The crude rate was 62.6 (95% CI: 51.9-73.2) for men and 6.8 (95% CI: 3.4-10.3) for women. The annual rate adjusted to the European Standard Population was 85.3 (95% CI:75.0-95.5) for men and 7.0 (95% CI:4.5-9.5) for women. From 1994 to 2018, the prevalence of smokers decreased in men (42.3% to 30.9%) as well as in the active population working in the industry (44.36% to 22.59%). Nevertheless, the car fleet, especially diesel, has increased considerably. The annual mean concentrations of air (PM10, PM2.5, O3, and NO2) and water (nitrates, arsenic, trihalomethanes) pollutants were within the regulatory limit values, but not the maximum levels. Conclusions The incidence of BC is one of the highest in men but not in women, despite the decrease in tobacco use and industrial activity (perhaps related to high latency after carcinogen exposure cessation) and despite the control of environmental pollution (the maximum regulatory limit probably needs to be lowered). Finally, a similar exposure to the carcinogen would result in a gender-specific differential incidence.
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Bonfill X, Martinez-Zapata MJ, Vernooij RWM, Sánchez MJ, Suárez-Varela MM, De la Cruz J, Emparanza JI, Ferrer M, Pijoan JI, Palou J, Schmidt S, Madrid E, Abraira V, Zamora J. Clinical interval and diagnostic characteristics in a cohort of bladder cancer patients in Spain: a multicenter observational study. BMC Res Notes 2017; 10:708. [PMID: 29212556 PMCID: PMC5719559 DOI: 10.1186/s13104-017-3024-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 11/29/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE We performed a cohort study in seven hospitals in Spain to determine the clinical characteristics of incident patients with bladder cancer, the diagnostic process, and the conditions that might affect health care interval times. RESULTS 314 patients with bladder cancer were included, 70.3 (Standard Deviation [SD] 11.2) years old and 85.0% male. Clinical stage was T1 in 45.9% of patients. The median interval time between first consultation and diagnosis was of 104.0 days (Inter quartile range [IQR]:112.0; range from 0 to 986), being shorter for those patients who attended a hospital for their first consultation. The median interval time between diagnosis and first treatment was of 0.0 days (IQR: 0.0; range from 0 to 366), being longer when the patient had a pathologic tumor stage ≥ T2a.
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Affiliation(s)
- Xavier Bonfill
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Barcelona, Spain.,Public Health and Clinical Epidemiology Service, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María José Martinez-Zapata
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain. .,Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Barcelona, Spain.
| | - Robin W M Vernooij
- Iberoamerican Cochrane Centre, Institute of Biomedical Research Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - María José Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada, Barcelona, Spain
| | - María Morales Suárez-Varela
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Javier De la Cruz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Hospital 12 de Octubre, Madrid, Spain
| | - José Ignacio Emparanza
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Clinical Epidemiology Unit, Hospital Universitario Donostia, BioDonostia, San Sebastian, Spain
| | - Montserrat Ferrer
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - José Ignacio Pijoan
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Clinical Epidemiology Unit, Hospital, Universitario Cruces. Biocruces, Barakaldo, Spain
| | - Joan Palou
- Fundació Puigvert, Barcelona, Spain.,Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Stefanie Schmidt
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Madrid
- Iberoamerican Cochrane Centre, Barcelona, Spain.,Biomedical Research Centre-Universidad de Valparaiso-Chile, Valparaiso, Chile.,Department of Public Health-School of Medicine, Universidad de Valparaiso-Chile, Valparaiso, Chile
| | - Víctor Abraira
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Javier Zamora
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Unidad de Bioestadística Clínica, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, UK
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Salinas-Sánchez AS, Sánchez-Sánchez F, Donate-Moreno MJ, Rubio-del-Campo A, Gimenez-Bachs JM, Lorenzo-Romero JG, Serrano-Oviedo L, Escribano J. Polymorphic deletions of the GSTT1 and GSTM1 genes and susceptibility to bladder cancer. BJU Int 2010; 107:1825-32. [DOI: 10.1111/j.1464-410x.2010.09683.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Galceran J, Ameijide A, Lluís Piñol J, Gumà J. Análisis de la incidencia, la supervivencia y la mortalidad según las principales localizaciones tumorales, 1985-2019: cáncer de vejiga urinaria. Med Clin (Barc) 2008; 131 Suppl 1:67-71. [DOI: 10.1016/s0025-7753(08)76437-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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