title: Blood cadmium may be associated with bladder carcinogenesis: the Belgian case-control study on bladder cancer.
abstract: BACKGROUND
  The aim of this study was to assess the relationship between exposure to cadmium and bladder cancer risk.
  
  
  METHODS
  We conducted a case-control study in Belgium and measured the blood levels of cadmium in 172 bladder cases and 359 population controls. The data were analyzed as tertiles after logarithmic transformation. Cut-off points were based on the levels among the controls. Logistic regression was performed to calculate odds ratios (ORs) for bladder cancer occurrence with corresponding 95% confidence intervals (95% CI).
  
  
  RESULTS
  After adjustment for sex, age, and occupational exposure to PAHs or aromatic amines, the OR for cadmium was 8.3 (95% CI 5.0-13.8) comparing the highest to the lowest tertile (p for trend <0.001). Additional adjustment for smoking (current cigarette smoking status, years of cigarette smoking and number of cigarettes smoked per day) decreased the OR, however it remained strongly significant (OR: 5.7; 95% CI 3.3-9.9).
  
  
  CONCLUSIONS
  Our study suggests that individuals with increased exposure to cadmium have an increased risk of bladder cancer. Future studies should expand on this investigation by studying a larger number of bladder cancer patients and by collecting extensive information on the lifetime occupational, residential, and environmental exposures to clarify the role of cadmium in bladder cancer.
authors.affiliation: Department of General Practice, Katholieke Universiteit Leuven, Comprehensive Cancer Institute Limburg, Belgium. Eliane.Kellen@med.kuleuven.be
authors.forename: Eliane
authors.initials: E
authors.lastname: Kellen
authors.forename: Maurice P
authors.initials: MP
authors.lastname: Zeegers
authors.forename: Elly Den
authors.initials: ED
authors.lastname: Hond
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
mesh_terms: D000368:Aged; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D000588:Amines / Q000009:adverse effects; D001530:Belgium / Q000453:epidemiology; D002104:Cadmium / Q000009:adverse effects* / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D016017:Odds Ratio; D011084:Polycyclic Aromatic Hydrocarbons / Q000009:adverse effects; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000097:blood / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000209:etiology
chemical_list: D000395:Air Pollutants, Occupational; D000588:Amines; D011084:Polycyclic Aromatic Hydrocarbons; D002104:Cadmium