Tobacco use and bladder cancer patterns in three western European countries.
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.
Van Hemelrijck
Mieke J J
MJ
Division of Public Health Practice, Harvard School of Public Health, Boston, MA, USA. mieke.vanhemelrijck@kcl.ac.uk
Michaud
Dominique S
DS
Connolly
Gregory N
GN
Kabir
Zubair
Z
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
D014028:Tobacco Smoke Pollution