Risk factors for bladder cancer (368/1700)

A 39yo coal miner who smokes, drinks and has a fam hx of bladder cancer is suffering from BPH. The most important risk factor for his bladder carcinoma is?
a. Fam hx
b. Smoking
c. Exposure to coal mine
d. BPH






























answer: B

Etiology of bladder cancer
• unknown, but environmental risk factors include

1. smoking (main factor – implicated in 60% of new cases)
2. aromatic amines: naphthylamines, benzidine, tryptophan, phenacetin metabolites
3. cyclophosphamide
4. prior Hx of radiation treatment to the pelvis
5. Schistosoma hematobium infection (associated with SCC)
6. chronic irritation: cystitis, chronic catheterization, bladder stones (associated with SCC)
7. aristolochic acid: associated with Balkan Nephropathy (renal failure, upper tract urothelial cancer) and Chinese Herbal Nephropathy