title: Tobacco use and bladder cancer patterns in three western European countries.
abstract: BACKGROUND
  Smoking accounts for >50% of bladder cancers (BCs) in men and 30% in women. Our aim is to explore this large discrepancy by contrasting countries with distinct smoking patterns and habits as these might explain sex differences for BC.
  
  
  METHODS
  Temporal patterns in BC incidence rates, lung cancer (LC) death rates, smoking prevalence and cigarette consumption across time by sex were analyzed by calculating annual percent changes (APCs), using joinpoint regression, for Spain (1973-97), Sweden (1958-97) and the UK (1960-97).
  
  
  RESULTS
  APCs for overall BC incidence rates were increasing for both sexes, ranging from 1.43% (1.25; 1.60) (British men) to 3.79% (3.15; 4.44) (Spanish men). APCs for overall LC death rates were also increasing in Sweden and Spain, but the UK showed decreasing APCs for LC death rates in men: -0.48% (-0.86; 0.10). Spain showed decreasing APCs for smoking prevalence among men and increasing APCs among women, -1.65% (-1.79; -1.51) and 2.48% (1.97; 3.00), respectively, but no differences by sex were found for the UK and Sweden.
  
  
  CONCLUSIONS
  Findings indirectly reflected lag-time of minimum 30 years between smoking and onset of BC. The lack of sex differences for APCs of BC across these countries suggests potential contributions of changes in other population exposure levels.
authors: Division of Public Health Practice, Harvard School of Public Health, Boston, MA, USA. mieke.vanhemelrijck@kcl.ac.uk
authors: Mieke J J
authors: MJ
authors: Van Hemelrijck
authors: Dominique S
authors: DS
authors: Michaud
authors: Gregory N
authors: GN
authors: Connolly
authors: Zubair
authors: Z
authors: Kabir
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000639:trends; D013030:Spain / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D014028:Tobacco Smoke Pollution; D006113:United Kingdom / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology
chemical_list: D014028:Tobacco Smoke Pollution