Urinary bladder cancer risk factors in Egypt: a multi-center case-control study
Menée en Egypte, cette étude multi-centrique (1 886 cas et 2 716 témoins) évalue l'association entre le tabagisme, un antécédent de bilharziose et un risque de cancer de la vessie
Background: We investigated associations between tobacco exposure, history of schistosomiasis, and bladder cancer risk in Egypt. Methods: We analyzed data from a multi-center case-control study (1,886 newly diagnosed and histologically confirmed cases and 2,716 age-, gender-, and residence-matched, population-based controls). Using unconditional logistic regression we estimated the covariate-adjusted odds ratios (OR) and 95% confidence interval (CI) of the associations. Results: Among men, cigarette smoking was associated with increased risk of urothelial carcinoma (UC) (OR = 1.8, 95% CI = 1.4, 2.2), but not squamous cell carcinoma (SCC); and smoking both waterpipes and cigarettes was associated with an even greater risk for the former UC (OR = 2.9, 95% CI = 2.1, 3.9) and a statistically significant risk for the latter (OR = 1.8, 95% CI = 1.2, 2.6). Among non-smoking men and women, exposure to environmental tobacco smoke was associated with an increased risk of UC. History of schistosomiasis was associated with increased risk of both UC (OR = 1.9, 95% CI = 1.2, 2.9) and SCC (OR = 1.9, 95% CI = 1.2, 3.0) in women and to a lesser extent (OR = 1.4, 95% CI = 1.2, 1.7 and OR = 1.4, 95% CI = 1.1, 1.7, for UC and SCC respectively) in men. Conclusions: This large study provides new evidence for an association between schistosomiasis and risk of not only SCC but also UC, and suggests that smoking both cigarettes and waterpipes is a significant risk factor for either type of bladder malignancy in Egyptian men. Impact: