title: Low awareness of risk factors among bladder cancer survivors: New evidence and a literature overview.
abstract: Data on urinary bladder cancer (UBC) patients' perceptions about causes of bladder cancer is limited, while this may be important knowledge for health prevention and education. We evaluated self-reported perceptions and beliefs about the causes of bladder cancer among UBC survivors in the Netherlands.
  
  
  
  UBC survivors identified through the Netherlands Cancer Registry from 2007 to 2012 were invited to participate. Patients who consented were asked to fill out a questionnaire, including questions on lifestyle characteristics, occupational and medical history, and family history of cancer. The final question was 'You have been diagnosed with bladder cancer. Do you have any idea what may have been the cause of your cancer?'.
  
  
  
  Of the 1793 UBC survivors included, 366 (20%) reported a possible cause for their bladder cancer. The most frequently reported suspected causes were smoking (10%), occupational exposure (5%), and heredity (2%). Smoking, occupational exposure and heredity were mentioned only slightly more frequently by participants with these risk factors (11%, 8%, and 5%, respectively) compared to the total population.
  
  
  
  Most UBC survivors did not suspect any cause that might have contributed to the development of their cancer. Even among participants with established risk factors for bladder cancer, these risk factors were not commonly perceived. This finding probably reflects the superficial knowledge of risk factors for bladder cancer in the population and highlights the importance of effective education on cancer prevention.
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Ellen.Westhoff@radboudumc.nl.
authors.forename: Ellen
authors.initials: E
authors.lastname: Westhoff
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Julia_Neumayer@hotmail.com.
authors.forename: Julia
authors.initials: J
authors.lastname: Maria de Oliveira-Neumayer
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands. Electronic address: Katja.Aben@radboudumc.nl.
authors.forename: Katja K
authors.initials: KK
authors.lastname: Aben
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Alina.Vrieling@radboudumc.nl.
authors.forename: Alina
authors.initials: A
authors.lastname: Vrieling
authors.affiliation: Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: Bart.Kiemeney@radboudumc.nl.
authors.forename: Lambertus A
authors.initials: LA
authors.lastname: Kiemeney
mesh_terms: D000368:Aged; D001294:Attitude to Health; D001364:Awareness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D001749:Urinary Bladder Neoplasms / Q000523:psychology*
keywords: Perception; Qualitative research; Questionnaires; Risk factors; Survivors; Urinary bladder neoplasms