title: Environmental tobacco smoke and arsenic methylation capacity are associated with urothelial carcinoma.
abstract: OBJECTIVE
  Cigarette smoking, exposure to secondhand smoke, and arsenic exposure are well known risk factors for developing urothelial carcinoma (UC). We investigated the combined effects of cigarette smoking, exposure to secondhand smoke, and the presence of urinary total arsenic on the risk of developing UC.
  
  
  METHODS
  We conducted a hospital-based, case-control study involving 261 UC patients and 672 cancer-free control individuals between September 2002 and May 2009.
  
  
  RESULTS
  Individuals who had smoked <100 cigarettes in their lifetime (never smokers) and had a high urinary total arsenic level (≥15.40 μg/g creatinine), and those who had smoked >100 cigarettes in their lifetime (ever smokers) and had a high urinary total arsenic level, had increased risks of developing UC (3.20-fold and 6.45-fold greater), respectively, compared to individuals who were never smokers and had a low urinary total arsenic level. Individuals who had high urinary total arsenic levels and had been exposed to secondhand smoke, and individuals with high urinary arsenic levels who had not been exposed to secondhand smoke, had increased chances (2.71-fold and 5.00-fold greater, respectively) of developing UC, compared to individuals who were not exposed to secondhand smoke and had low urinary total arsenic levels. Ever smokers who had been exposed to secondhand smoke and had a high urinary total arsenic level had the greatest increased risk for developing UC (10.82-fold greater).
  
  
  CONCLUSIONS
  Individuals in a Taiwanese population who smoked cigarettes, were exposed to secondhand smoke, and a high urinary total arsenic level, had a significant risk for developing UC.
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan; Department of Urology, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan.
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Wu
authors.forename: Mei-Chieh
authors.initials: MC
authors.lastname: Chen
authors.forename: Yung-Kai
authors.initials: YK
authors.lastname: Huang
authors.forename: Chao-Yuan
authors.initials: CY
authors.lastname: Huang
authors.forename: Li-An
authors.initials: LA
authors.lastname: Lai
authors.forename: Chi-Jung
authors.initials: CJ
authors.lastname: Chung
authors.forename: Horng-Sheng
authors.initials: HS
authors.lastname: Shiue
authors.forename: Yeong-Shiau
authors.initials: YS
authors.lastname: Pu
authors.forename: Ying-Chin
authors.initials: YC
authors.lastname: Lin
authors.forename: Bor-Cheng
authors.initials: BC
authors.lastname: Han
authors.forename: Yuan-Hung
authors.initials: YH
authors.lastname: Wang
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Hsueh
mesh_terms: D000328:Adult; D000368:Aged; D001151:Arsenic / Q000009:adverse effects* / Q000652:urine; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008745:Methylation; D008875:Middle Aged; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014571:Urologic Neoplasms / Q000209:etiology*
chemical_list: D014028:Tobacco Smoke Pollution; D001151:Arsenic
keywords: arsenic methylation capacity; cigarette smoking; environmental tobacco smoke; urothelial carcinoma