title: Duration and intensity of tobacco smoking and the risk of papillary and non-papillary transitional cell carcinoma of the bladder.
abstract: OBJECTIVE
  To evaluate the impact of tobacco smoking on specific histological subtypes of transitional cell carcinoma of the bladder (TCC).
  
  
  METHODS
  Between 2003 and 2009, we conducted a hospital-based case-control study in Italy, enrolling 531 incident TCC cases and 524 cancer-free matched patients. Odds ratios (OR) and corresponding 95% confidence intervals (CI) were estimated through multiple logistic regression models.
  
  
  RESULTS
  Compared to never smokers, TCC risk was threefold higher in former smokers (95% CI 2.07-4.18) and more than sixfold higher in current smokers (95% CI 4.54-9.85). TCC risk steadily increased with increasing intensity (OR for ≥25 cigarettes/day 8.75; 95% CI 3.40-22.55) and duration of smoking (OR for ≥50 years 5.46; 95% CI 2.60-11.49). No heterogeneity emerged between papillary and non-papillary TCCs for smoking intensity and duration, but the risk for those who had smoked for ≥50 years was twice for non-papillary TCC (OR 10.88) compared with papillary one (OR 4.76). Among current smokers, the risk for a 10-year increase in duration grew across strata of intensity (p-trend = 0.046). Conversely, the risk for a 5-cigarette/day increase in smoking intensity was quite steady across strata of duration (p-trend = 0.18).
  
  
  CONCLUSIONS
  Study results suggested that duration of smoking outweighs intensity in determining TCC risk, with limited differences across histological subtypes. Elimination of tobacco smoking may prevent about 65 % of TCCs.
authors: Unit of Epidemiology and Biostatistics, IRCCS - CRO Aviano National Cancer Institute, Via F. Gallini 2, 33081, Aviano, PN, Italy, polesel@cro.it.
authors: Jerry
authors: J
authors: Polesel
authors: Cristina
authors: C
authors: Bosetti
authors: Matteo
authors: M
authors: di Maso
authors: Maurizio
authors: M
authors: Montella
authors: Massimo
authors: M
authors: Libra
authors: Antonio
authors: A
authors: Garbeglio
authors: Antonella
authors: A
authors: Zucchetto
authors: Federica
authors: F
authors: Turati
authors: Renato
authors: R
authors: Talamini
authors: Carlo
authors: C
authors: La Vecchia
authors: Diego
authors: D
authors: Serraino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D055815:Young Adult