Diet and bladder cancer in Spain: a multi-centre case-control study

C15:0 and C17:0 partially mediate the association of milk and dairy products with bladder cancer risk

The relationship between saturated fatty acids (SFA) and bladder cancer (BC) risk has been conflicting. Our aim was to investigate the relationship between erythrocyte membrane SFA and BC risk. A total of 404 participants were enrolled in the study (including 112 cases and 292 controls). A validated food frequency questionnaire was used to assess the food intake. The constitutive composition of fatty acids in the erythrocyte membrane was measured by gas chromatography. After adjustment for BC risk factors, SFA had no significant association with BC risk. However, C18:0 was positively linked with BC risk with an odds ratio (OR; 95% CI) of 2.99 (1.37-6.53). In contrast, very-long-chain saturated fatty acids (VLCSFA), especially C24:0, were negatively related to BC risk with an OR (95% CI) of 0.28 (0.12-0.65) for VLCSFA and 0.33 (0.15-0.75) for C24:0. Higher total odd-chain SFA (C15:0 and C17:0) were associated with a lower risk of BC with OR (95% CI) of 0.18 (0.076-0.44), 0.18 (0.068-0.47), 0.34 (0.14-0.81), respectively. After subgroup analysis, the protective effects C15:0 and C17:0 were still remained. Receiver operating characteristic analysis displayed that the combination of C15:0 and C17:0 indexes increased the accurate predictive rate of BC risk. Further mediation effect analysis showed that C15:0 and C17:0 could be used as partial mediation effectors for milk and dairy products and bladder carcinogenesis. Overall, the combination of odd-chain SFA (C15:0 and C17:0) in the erythrocyte membrane could serve as a reliable mediator and predictor, indicating a relationship between a high intake of milk and dairy products and a lower risk of BC.

Relationship between Bladder Cancer, Nutritional Supply, and Treatment Strategies: A Comprehensive Review

Bladder cancer (BC) is the predominant neoplasm affecting the urinary system and ranks among the most widespread malignancies globally. The causes of bladder cancer include genetic factors; age; sex; and lifestyle factors, such as imbalanced nutrition, obesity, and metabolic disorders. The lack of proper nutrient intake leads to the development of bladder cancer because insufficient nutrients are consumed to prevent this disease. The purpose of this review was to analyze the nutrients closely linked to the onset and advancement of bladder cancer and to explore the relationship between dietary nutrients and bladder cancer. Particular emphasis was placed on nutrients that are frequently ingested in daily life, including sugar, fat, protein, and others. The focus of this research was to analyze how nutritional intake before and after surgery affects the recovery process of patients who have been diagnosed with bladder cancer. This article seeks to increase awareness among both society and the medical community about the significance of implementing appropriate dietary nutrition to reduce the chances of developing bladder cancer, enhance perioperative care for patients with bladder cancer, and aid in their recuperation.

Meat Intake and the Risk of Bladder Cancer: A Systematic Review and Meta-Analysis of Observational Studies

The evidence for the association between meat intake and the risk of bladder cancer (BC) is still inconclusive. A total of 29 studies involving 1,475,125 participants and 18,836 cases of BC were included in the meta-analysis. Among these studies, 11 reported total meat intake, 20 reported red meat intake, 19 reported processed meat intake, 15 reported white meat intake, and 15 reported fish intake. The results suggested that there was an overall increase in BC risk associated with total meat intake (RR = 1.10; 95% confidence interval: 0.92-1.31; I² = 55.20%; P = 0.014), and a higher red meat (RR = 1.23; 95% CI: 1.08-1.39; I² = 51.30%; P = 0.004) or processed meat (RR = 1.16; 95% CI: 1.08-1.25; I² = 28.00%; P = 0.125) intake may increase the risk of BC. In contrast, a higher intake of fish (RR = 0.80; 95% CI: 0.67-0.95; I² = 62.90%; P = 0.001) was inversely associated with the risk of BC. Moreover, we did not observe an association between white meat (RR = 0.96; 95% CI: 0.83-1.10; I² = 53.70%; P = 0.007) and the risk of BC. Our findings suggested that dietary intervention may be an effective approach to preventing BC, which still needs to be confirmed by further well-designed observational studies.

Dietary fats and their sources in association with the risk of bladder cancer: A pooled analysis of 11 prospective cohort studies

The effects of fat intake from different dietary sources on bladder cancer (BC) risk remains unidentified. Therefore, the present study aimed to investigate the association between fat intakes and BC risk by merging world data on this topic. Data from 11 cohort studies in the BLadder cancer Epidemiology and Nutritional Determinants (BLEND) study, provided sufficient information on fat intake for a total of 2731 BC cases and 544 452 noncases, which yielded 5 400 168 person-years of follow-up. Hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox-regression models stratified on cohort. Analyses were adjusted for total energy intake in kilocalories, gender, smoking status (model-1) and additionally for sugar and sugar products, beers, wine, dressing and plant-based and fruits intakes (model-2). Among women, an inverse association was observed between mono-unsaturated fatty acids (MUFAs) and BC risk (HR comparing the highest with the lowest tertile: 0.73, 95% CI: 0.58-0.93, P-trend = .01). Overall, this preventative effect of MUFAs on BC risk was only observed for the nonmuscle invasive bladder cancer (NMIBC) subtype (HR: 0.69, 95% CI: 0.53-0.91, P-trend = .004). Among men, a higher intake of total cholesterol was associated with an increased BC risk (HR: 1.37, 95% CI: 1.16-1.61, P-trend = .01). No other significant associations were observed. This large prospective study adds new insights into the role of fat and oils in BC carcinogenesis, showing an inverse association between consumption of MUFAs and the development of BC among women and a direct association between higher intakes of dietary cholesterol and BC risk among men.

Association of dietary tomato intake with bladder cancer risk in a prospective cohort of 101,683 individuals with 12.5 years of follow-up

Previous studies have provided limited evidence for the effect of tomato intake on bladder cancer incidence. This study aimed to evaluate the association between dietary tomato or lycopene consumption and bladder cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression model adjusting for confounders. After a median of 12.5 years of follow-up, 774 incident bladder cancer cases were identified. We found no statistically significant association between dietary intake of raw tomatoes and bladder cancer risk (Adjusted model: HR_{Q5 VS Q1} = 1.20, 95% CI: 0.95-1.52; P for trend = 0.243). Dietary intakes of tomato catsup, tomato salsa and tomato juice were also not associated with the risk of bladder cancer (all P for trend > 0.05). There was no statistically significant association between dietary consumption of lycopene and bladder cancer risk (Adjusted model: HR_{Q5 vs. Q1} = 1.04, 95% CI 0.82-1.33; P for trend = 0.590). In summary, analysis of the PLCO study suggested that dietary consumption of tomato or lycopene was not associated with the risk of bladder cancer.

Adherence to a Western dietary pattern and risk of bladder cancer: A pooled analysis of 13 cohort studies of the Bladder Cancer Epidemiology and Nutritional Determinants international study

Little is known about the association of diet with risk of bladder cancer. This might be due to the fact that the majority of studies have focused on single food items, rather than dietary patterns, which may better capture any influence of diet on bladder cancer risk. We aimed to investigate the association between a measure of Western dietary pattern and bladder cancer risk. Associations between adherence to a Western dietary pattern and risk of developing bladder cancer were assessed by pooling data from 13 prospective cohort studies in the "BLadder cancer Epidemiology and Nutritional Determinants" (BLEND) study and applying Cox regression analysis. Dietary data from 580 768 study participants, including 3401 incident cases, and 577 367 noncases were analyzed. A direct and significant association was observed between higher adherence to a Western dietary pattern and risk of bladder cancer (hazard ratio (HR) comparing highest with lowest tertile scores: 1.54, 95% confidence interval (CI): 1.37, 1.72; P-trend = .001). This association was observed for men (HR comparing highest with lowest tertile scores: 1.72; 95% CI: 1.51, 1.96; P-trend = .001), but not women (P-het = .001). Results were consistent with HR above 1.00 after stratification on cancer subtypes (nonmuscle-invasive and muscle-invasive bladder cancer). We found evidence that adherence to a Western dietary pattern is associated with an increased risk of bladder cancer for men but not women.

Carbohydrates, Glycemic Index, and Glycemic Load in Relation to Bladder Cancer Risk

Objective: Epidemiologic studies investigating the association between dietary carbohydrates as well as glycemic index and glycemic load (markers of carbohydrate quality) and bladder cancer risk have yielded inconsistent results. The aim of the present meta-analysis is to summarize the evidence on this association. Materials and Methods: A comprehensive literature search of articles published by December 2019 was performed in PubMed, Scopus, and Web of Science databases. A random-effects model was used to calculate the pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Results: Twelve observational studies were included in the final analysis. There was no evidence of an association between consumption of carbohydrates and bladder cancer risk (pooled OR, 1.04; 95% CI, 0.92-1.17). No statistically significant association between glycemic load and bladder cancer was likewise found (pooled OR, 1.10; 95% CI, 0.85-1.42). However, there was a significant positive association between glycemic index and bladder cancer risk (pooled OR, 1.25; 95% CI, 1.11-1.41). In the dose-response analysis, the pooled OR (95% CI) per 10 units of glycemic index per day was 1.02 (95% CI, 1.01-1.04). Conclusion: In this meta-analysis, glycemic index showed a positive linear association with bladder cancer risk.

Dietary fiber intake and the risk of bladder cancer in the Prostate, Lung, Colorectal and Ovarian (PLCO) cohort

Dietary fiber intake has been implicated as a protective factor for several human cancers in multiple epidemiologic studies. However, little is known about the effect of fiber intake on bladder cancer. This study examines the association between dietary fiber intake and bladder cancer risk among participants in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. A total of 101 721 participants were included in this study as they completed both the baseline questionnaire and the diet history questionnaire (cancer free before completion of the diet history questionnaire). Hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were estimated using the Cox proportional hazards regression model. After a median of 12.5 years of follow-up, 776 new cases of bladder cancer were identified. Higher intake of total fiber, insoluble fiber and soluble fiber were not significantly associated with a reduced risk of bladder cancer. The multi-adjusted HRs (95 CIs) of highest versus lowest tertile of intake were 0.83 (0.66-1.04) for total fiber (P for trend = 0.098), 0.83 (95% CI: 0.67-1.03) for insoluble fiber (P for trend = 0.092) and 0.86 (95% CI: 0.68-1.08) for soluble fiber (P for trend = 0.168), respectively. There was no significant interaction of potential confounders, including education, body mass index and smoking status, with total fiber intake on bladder cancer risk. In summary, the findings of this prospective study show that there is no obvious evidence for a link between dietary fiber consumption and bladder cancer risk. Further large cohort studies are warranted to confirm these findings.

Dairy Product Consumption and Bladder Cancer Risk: A Meta-Analysis

To explore the potential relationship between dairy product consumption and bladder cancer risk, we retrieved eligible studies published up to March 15, 2018, via online database search and manual review of the selected articles. Summary relative risk (RR) estimates were calculated using random-effects models based on high to low intake values. Inter-study heterogeneity was explored using stratified analyses of study design, geographic region, or whether studies adjusted for the confounders age, sex, body mass index, smoking, and education level. We extracted data from 16 studies on milk (5,193 subjects) and 10 studies on dairy products (20,434 subjects). The total study population included 220,952 individuals. Dairy product intake and bladder cancer risk were significantly associated, and milk intake and bladder cancer risk more so. Stratified analysis revealed that the trend was more pronounced in case-control studies, and in studies with impact factor <3 and in Asia. The relationship was confirmed after adjusting for sex and Newcastle-Ottawa Scale score of 7 and 8. Our study shows an inverse association between milk consumption and bladder cancer risk.

Milk and Dairy Product Consumption and Bladder Cancer Risk: A Systematic Review and Meta-Analysis of Observational Studies

Some studies have reported that milk and dairy product consumption reduces bladder cancer incidence, whereas others have reported null or opposite findings. This meta-analysis of 26 cohort and case-control studies has been conducted to pool the risk of the association between milk and dairy products and bladder cancer. A systematic search in MEDLINE, EMBASE, and the Web of Science (from inception to 30 April 2018) was conducted. Random-effects models were used to compute pooled estimates of RR for high or medium compared with low consumption of milk and dairy. Sensitivity analyses were conducted. Subgroup analyses were performed based on type of dairy, gender, geographic location, and type of study design. Random-effects meta-regression was used to evaluate other confounding factors. Overall, medium compared with low consumption was associated with lower pooled risk of bladder cancer for total dairy products (RR = 0.90; 95% CI: 0.81, 0.98), milk (RR = 0.90; 95% CI: 0.82, 0.98), and fermented dairy products (RR = 0.87; 95% CI: 0.79, 0.96). The inverse association for milk consumption was stronger in Asians (RR = 0.79; 95% CI: 0.59, 0.98) and in cohort design studies (RR = 0.85; 95% CI: 0.71, 0.99). Moreover, high compared with low consumption was significantly associated with a lower pooled risk for milk (RR = 0.89; 95% CI: 0.81, 0.98) and fermented dairy products (RR = 0.78; 95% CI: 0.61, 0.94). However, high compared with low consumption of whole milk was significantly associated with a higher risk (RR = 1.21; 95% CI: 1.04, 1.38). The statistical heterogeneity was considerable. In conclusion, the present meta-analysis suggests a decreased risk of bladder cancer associated with medium consumption of total dairy products and with medium and high consumption of milk and fermented dairy products. An increased risk of bladder cancer was observed with high consumption of whole milk. Interpretations of the results should be made with caution. This review was registered at www.crd.york.ac.uk/prospero as CRD42018097020.

Non-Occupational Risk Factors for Bladder Cancer a Case-Control Study

Aims

The aim of this study was to determine non-occupational risk factors for bladder cancer in Serbia.

Methods and design

A hospital-based, case-control study included 130 newly diagnosed bladder cancer patients and the same number of individually matched controls with respect to sex, age (± 2 years) and type of residence (rural or urban), from the Clinical Center of Serbia in Belgrade and from the Clinical Center in Kragujevac in central Serbia. The study took place from June 1997 to March 1999.

Results

According to multivariate logistic regression analysis, there was an association between: frequency of daily urination (OR = 0.18; 95% CI = 0.08-0.39); consumption of liver (OR = 13.81; 95% CI = 2.49-76.69), canned meat (OR = 8.38; 95% CI = 1.74-40.36), fruit juices (OR = 0.08; 95% CI = 0.01-0.56); the highest fertile of pork (OR = 4.55; 95% CI = 1.30-15.93), cabbage (OR = 0.25; 95% CI = 0.06-1.01) and vinegar (OR = 4.41; 95% CI = 1.18-16.50) intake and risk for bladder cancer.

Conclusions

Consumption of liver, canned meat, pork (h vs I tertile) and vinegar (m vs I tertile) was indicated as a risk factor for bladder cancer, whereas frequent daily urination, consumption of fruit juices and cabbage (h vs I fertile) were indicated as protective factors.

Milk/dairy products consumption and gastric cancer: an update meta-analysis of epidemiological studies

The relationship between dairy consumption and gastric cancer risk has not been well studied. We therefore performed a update meta-analysis to evaluate the relationship. Published cohort and case-control studies were identified via computer searches and reviewing the reference lists of the key articles. Random effects meta-analysis was used to pool effects from 5 cohort and 29 case-control studies. The odds ratio for the overall association between dairy consumption and gastric cancer was 1.20 (95%confidence interval: 1.04–1.39). The combined risk estimate was similar for population-based case-control studies (odds ratio = 1.27, 95%confidence interval: 1.00–1.61), but was reduced for hospital-based studies (odds ratio = 1.22; 95%confidence interval: 0.95–1.57) and cohort studies (odds ratio = 0.99; 95%confidence interval: 0.77–1.28). There was high heterogeneity in overall analyses. In the population-based subgroup analyses, the odds ratio was 0.96 (95%confidence interval: 0.69–1.34) when considering five studies assessing exposure two or more years before interview, and the association strengthened (odds ratio = 1.91, 95%confidence interval: 1.60–2.28) when dairy consumption was evaluated one year or less prior to interview. In conclusion, we found adverse effect of dairy consumption associated with gastric cancer.

Red and processed meat consumption and risk of bladder cancer: a dose-response meta-analysis of epidemiological studies

Background/objectives

Several epidemiological studies have analyzed the associations between red and processed meat and bladder cancer risk but the shape and strength of the associations are still unclear. Therefore, we conducted a dose–response meta-analysis to quantify the potential association between red and processed meat and bladder cancer risk.

Methods

Relevant studies were identified by searching the PubMed database through January 2016 and reviewing the reference lists of the retrieved articles. Results were combined using random-effects models.

Results

Five cohort studies with 3262 cases and 1,038,787 participants and 8 cases–control studies with 7009 cases and 27,240 participants met the inclusion criteria. Red meat was linearly associated with bladder cancer risk in case–control studies, with a pooled RR of 1.51 (95% confidence interval (CI) 1.13, 2.02) for every 100 g increase per day, while no association was observed among cohort studies (P heterogeneity across study design = 0.02). Based on both case–control and cohort studies, the pooled relative risk (RR) for every 50 g increase of processed meat per day was 1.20 (95% CI 1.06, 1.37) (P heterogeneity across study design = 0.22).

Conclusions

This meta-analysis suggests that processed meat may be positively associated with bladder cancer risk. A positive association between red meat and risk of bladder cancer was observed only in case–control studies, while no association was observe in prospective studies.

Electronic supplementary material

The online version of this article (doi:10.1007/s00394-016-1356-0) contains supplementary material, which is available to authorized users.

The impact of nutrition in urogenital cancers

Prostate, bladder and kidney cancers remain the most common cancers of the urinary tract. Despite improved primary prevention, detection and treatment, the incidence of age-related cancers of the urinary tract is likely to rise as a result of global population ageing. An association of diet with prostate, bladder and kidney carcinogenesis is plausible since the majority of metabolites, including carcinogens, are excreted through the urinary tract. Moreover, large regional differences in incidence rates of urologic tumours exist throughout the world. These rates change when people relocate to different geographic areas, which is suggestive of a strong environmental influence. As a result of these observations, numerous studies have been conducted to assess the effects of diet and nutritional status in kidney, bladder and prostate carcinogenesis. Here, we review the literature assessing the effect of diet and nutritional status on urological cancer risk, which has attracted the most interest.

Association of vitamin C, vitamin D, vitamin E and risk of bladder cancer: a dose-response meta-analysis

A dose-response meta-analysis was conducted to assess the association of vitamin C, D, E with risk of bladder cancer. Pertinent studies were identified in PubMed and Embase. The random-effect model was used. The relative risk (95% confidence interval) of bladder cancer was 0.99 (0.95–1.03) for every 100 IU/day increment in vitamin D from diet plus supplement and 0.95 (0.90–1.00) for every 10 nmol/L increment in circulating vitamin D. The effect for every 10 mg/day increment was 0.96 (0.90–1.02) for vitamin E from diet plus supplement, 0.83 (0.72–0.95) from diet and 0.88 (0.67–1.15) from supplement, and the effect was 0.84 (0.76–0.94) for every 1 mg/dL increment in circulating α-Tocopherol and 1.22 (1.00–1.49) for every 0.1 mg/dL increment in circulating γ-Tocopherol. The observed association for vitamin D and vitamin E was significant among smokers but not among non-smokers. No significant association was found between vitamin C and risk of bladder cancer in the dose-response analysis. Based on the dose-response analysis, the risk of bladder cancer might be inversely associated with vitamin D and E (especially α-Tocopherol), but positively associated with γ-Tocopherol.

[Secondary prevention in patients with superficial urothelial carcinoma]

BACKGROUND

Urothelial cancer is the 4th most common cancer in men and the 7th most common malignancy in women in Germany. 95 % of all tumors of the urinary bladder are urothelial carcinomas. At the time of diagnosis approximately 80 % of these carcinomas are not invasive. The affection is often multicentric. Approximately 10-15 % of the tumors develop into muscle-invasive growth. In this prospective study, we analyzed measures patients independently took to reduce their risk of bladder cancer recurrence.

MATERIALS AND METHODS

During the period January 2012 to December 2013, we surveyed a total of 97 patients with superficial transitional cell carcinoma (pTa). The question was how far the diagnosis of urothelial cancer has changed their lives, eating and drinking habits or whether follow-up consultations had been carried out regularly. Furthermore, we recorded whether they accepted psychological care or had autonomously adopted prophylactic measures, as well as changed their smoking habits, if they had smoked.

RESULTS

Of the 97 patients questioned, there were 79 men and 18 women (56 smokers and 41 nonsmokers). The median age was 71 years (range 36-96 years). For 22 patients (22.7 %), the diagnosis resulted in no changes. In 33 patients the changes were small (44 %), moderate in 20 (26.7 %), in 14 (18.6 %) strong and very strong in 8 (10.7 %). A total of 25 patients (25.8 %) changed their eating habits. In all, 49 patients changed their drinking habits; 48 patients claimed to drink more (> 2.0 L/day). One patient reduced his drinking amount. Regarding smoking, 40 patients (71.4 %) had stopped and 7 (12.5 %) reduced consumption, while 6 patients (10.7 %) had not changed their smoking habits. Overall, 44 patients (45.4 %) changed their physical activity: 11 (25 %) exercised more, 8 (18.1 %) less. Only 3 patients (3.1 %) used psycho-oncological care and 39 (40.2 %) patients used supportive/complementary medicine measures of favorablly influence their disease (mistletoe therapy, vitamin supplements). In addition, 22 patients (22.7 %) sought advice from their physician. However, 45.4 % of all patients did not believe in the success of their measures taken.

CONCLUSION

Of all patients diagnosed with urothelial carcinoma, 77.3 % reported a change in their living habits and they were willing to take specific steps, such as giving up smoking, being more physically active, changing drinking and eating habits in order to positively influence their disease. However, almost half of the patients (45.4 %) did not believe in a resounding success of their measures taken.

Intake of fruit and vegetables and risk of bladder cancer: a dose-response meta-analysis of observational studies

BACKGROUND

Observational studies suggest an association between fruit and vegetables intake and risk of bladder cancer, but the results are controversial.

METHODS

We therefore summarized the evidence from observational studies in categorical, linear, and nonlinear, dose-response meta-analysis. Pertinent studies were identified by searching EMBASE and PubMed from their inception to August 2013.

RESULTS

Thirty-one observational studies involving 12,610 cases and 1,121,649 participants were included. The combined rate ratio (RR, 95 % CI) of bladder cancer for the highest versus lowest intake was 0.83 (0.69-0.99) for total fruit and vegetables, 0.81 (0.70-0.93) for total vegetables, 0.77 (0.69-0.87) for total fruit, 0.84 (0.77-0.91) for cruciferous vegetables, 0.79 (0.68-0.91) for citrus fruits, and 0.74 (0.66-0.84) for yellow-orange vegetables. Subgroup analysis showed study design and gender as possible sources of heterogeneity. A nonlinear relationship was found of citrus fruits intake with risk of bladder cancer (P for nonlinearity = 0.018), and the RRs (95 % CI) of bladder cancer were 0.87 (0.78-0.96), 0.80 (0.67-0.94), 0.79 (0.66-0.94), 0.79 (0.65-0.96), and 0.79 (0.64-0.99) for 30, 60, 90, 120, and 150 g/day. A nonlinear relationship was also found of yellow-orange vegetable intake with risk of bladder cancer risk (P for nonlinearity = 0.033). Some evidence of publication bias was observed for fruit, citrus fruits, and yellow-orange vegetables.

CONCLUSION

This meta-analysis supports the hypothesis that intakes of fruit and vegetables may reduce the risk of bladder cancer. Future well-designed studies are required to confirm this finding.

Vitamin A and risk of bladder cancer: a meta-analysis of epidemiological studies

BACKGROUND

Epidemiological studies have reported the preventive effect of vitamin A intake on bladder cancer. However, the findings are inconsistent. To address this issue we conducted a meta-analysis to investigate the quantitative effects of vitamin A on bladder cancer.

METHODS

We searched MEDLINE and Embase databases and the references of the relevant articles in English to include studies on dietary or blood vitamin A for the risk of bladder cancer. We performed a meta-analysis using both fixed-effects and random-effects models.

RESULTS

Twenty-five articles on dietary vitamin A or blood vitamin A were included according to the eligibility criteria. The pooled risk estimates of bladder cancer were 0.82 (95% CI 0.65, 0.95) for total vitamin A intake, 0.88 (95% CI 0.73, 1.02) for retinol intake, and 0.64 (95% CI 0.38, 0.90) for blood retinol levels. We also found inverse associations between subtypes of carotenoids and bladder cancer risk.

CONCLUSION

The findings of this meta-analysis indicate that high vitamin A intake was associated with a lower risk of bladder cancer. Larger studies with prospective design and rigorous methodology should be considered to validate the current findings.

Crosstalk among dietary polyunsaturated fatty acids, urolithiasis, chronic inflammation, and urinary tract tumor risk

Based on a consistent bulk of experimental and epidemiologic works, we proposed that abnormal metabolism and/or dietary deprivation of essential polyunsaturated fatty acids by inducing a chronic and subclinical essential fatty acid deficiency (EFAD) in urothelial cell membranes may enhance the risk for urinary tract tumor (UTT) development. This threat may be enhanced by the unusual fact that the fatty-acid profile of the normal urothelium is similar to that reported in EFAD. The risk for UTT may be worsened when coexisting with a low-grade chronic inflammation (LGCI) state induced by urolithiasis or disbalance management of peroxides, free radical molecules, and their quenchers. There is cumulative evidence linking the LGCI of the urinary tract mucosa, calculi, and UTT, due to the long-standing release of promitotic, promutagen, and pro-inflammatory antiapoptotic cytokines in these conditions. The dual role played by pro- and anti-inflammatory eicosanoids and bioactive lipids, cytokines, and the disbalance of lipid peroxidation is discussed, concluding that the moderate, long-standing consumption or dietary supplementation of ω-3 PUFAs may improve the chances of avoiding UTT development.

Macronutrient intake and risk of urothelial cell carcinoma in the European prospective investigation into cancer and nutrition

Previous studies have suggested that dietary factors may be important in the development of bladder cancer. We examined macronutrient intake in relation to risk of urothelial cell carcinoma among 469,339 men and women in the European Prospective Investigation into Cancer and Nutrition. Associations were examined using Cox regression, stratified by sex, age at recruitment and centre and further adjusted for smoking status and duration, body mass index and total energy intake. After an average of 11.3 years of follow-up, 1,416 new cases of urothelial cell carcinoma were identified. After allowing for measurement error, a 3% increase in the consumption of energy intake from animal protein was associated with a 15% higher risk (95% confidence interval [CI]: 3-30%; p(trend) = 0.01) and a 2% increase in energy from plant protein intake was associated with a 23% lower risk (95% CI: 36-7%, p(trend) = 0.006). Dietary intake of fat, carbohydrate, fibre or calcium was not associated with risk. These findings suggest that animal and/or plant protein may affect the risk of urothelial cell carcinoma, and examination of these associations in other studies is needed.

Dietary intake of meat, fruits, vegetables, and selective micronutrients and risk of bladder cancer in the New England region of the United States

Background:

Despite many studies on diet and bladder cancer, there are areas that remain unexplored including meat mutagens, specific vegetable groups, and vitamins from diet.

Methods:

We conducted a population-based case–control study of bladder cancer in Maine, New Hampshire, and Vermont. A total of 1171 cases were ascertained through hospital pathology records and cancer registries from 2001 to 2004. Overall, 1418 controls were identified from the Department of Motor Vehicles (<65 years) and Center for Medicaid and Medicare Services (65–79 years) and were frequency-matched to cases by state, sex, and age (within 5 years). Diet was assessed with a self-administered Diet History Questionnaire. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI).

Results:

Processed meat intake was positively associated with bladder cancer (highest vs lowest quartile OR: 1.28; 95% CI: 1.00–1.65; P_trend=0.035), with a stronger association for processed red meat (OR: 1.41; 95% CI: 1.08–1.84; P_trend=0.024). There were no associations between intake of fruits or vegetables and bladder cancer. We did, however, observe an inverse association with vitamin B12 intake (OR: 0.77; 95% CI: 0.61–0.99; P=0.019).

Conclusion:

Vitamin B12 from diet may be protective against bladder cancer, whereas consuming processed meat may increase risk.

Intake of red meat and heterocyclic amines, metabolic pathway genes and bladder cancer risk

We analyzed the association between meat intake, heterocyclic amines (HCAs) and bladder cancer (BC) risk in a large case-control study comprised of 884 BC cases and 878 healthy controls, recruited from 1999 to 2009. Epidemiologic and dietary data were collected via an in-person interview. Compared to the lowest quartile of red meat intake, the odds ratios (ORs) for the second, third and fourth quartiles were 1.17 (95% CI: 0.87-1.58), 1.47 (95% CI: 1.09-1.99) and 1.95 (95% CI: 1.41-2.68), respectively, (p-for trend <0.001). In a subset of participants with intakes of HCAs available, compared with those with the lowest quartile of intake, the ORs for the second, third and fourth quartiles were 1.47 (95% CI: 0.60-3.64), 2.58 (95% CI: 1.09-6.11) and 3.32 (95% CI: 1.37-8.01), respectively, (p for trend <0.001). In cumulative analysis of SNPs in the pathway, compared with subjects carrying 0-4 unfavorable genotypes, subjects carrying 5 and 6 or more unfavorable genotypes were at 1.60-fold (95% CI: 1.20-2.12) and 2.37-fold (95% CI: 1.82-3.10) increased risk, respectively. Moreover, subjects carrying six or more unfavorable genotypes and whose red meat intake was in the highest quartile were at 5.09-fold increased risk (95% CI: 2.89-8.96; p < 0.001). These results strongly support that high red meat intake, high intake of HCAs and carrying high number of unfavorable genotypes in the HCA metabolic pathways are associated with increased risk of BC in the study population.

Milk and dairy consumption and risk of bladder cancer: a meta-analysis

OBJECTIVE

To explore potential relations between the intake of milk or dairy products and the risk of bladder cancer.

METHODS

Eligible studies published up to May 2011 were retrieved via both computer searches and manual review of references. Random-effects models were used to calculate summary relative risk estimates (SRRE) based on high-contrast to low-intake values. Sensitivity and influence analyses were conducted, and heterogeneity among study results was explored through stratified analyses by study design, gender, geographic region, year of publication, or whether or not adjustment for several confounders (ie, age, gender, body mass index, smoking, and total energy intake).

RESULTS

We extracted data from 14 studies on milk (involving 4879 cases) and 6 studies on dairy products (3087 cases). The total study population was up to 324,241 individuals. Overall, there was no significant association between milk intake and bladder cancer (SRRE 0.89, 95% CI 0.77-1.02). However, an inverse association was found in the United States (SRRE 0.88, 95% CI .79-.99). In addition, no significant association was observed between consumption of dairy products and risk of bladder cancer (SRRE 0.95, 95% CI .71-1.27), though an inverse association was detected in the Japanese population (SRRE 0.56, 95% CI .40-.80).

CONCLUSION

There appears to be enough evidence to support the null hypothesis. The overall result was not statistically significant. The findings of this meta-analysis are not supportive of an independent relationship between the intake of milk or dairy products and the risk of bladder cancer. However, these findings are based on limited research. Further efforts should be made to confirm these findings.

Sugars in diet and risk of cancer in the NIH-AARP Diet and Health Study

Prospective epidemiologic data on the effects of different types of dietary sugars on cancer incidence have been limited. In this report, we investigated the association of total sugars, sucrose, fructose, added sugars, added sucrose and added fructose in the diet with risk of 24 malignancies. Participants (n = 435,674) aged 50-71 years from the NIH-AARP Diet and Health Study were followed for 7.2 years. The intake of individual sugars was assessed using a 124-item food frequency questionnaire (FFQ). Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) in multivariable models adjusted for confounding factors pertinent to individual cancers. We identified 29,099 cancer cases in men and 13,355 cases in women. In gender-combined analyses, added sugars were positively associated with risk of esophageal adenocarcinoma (HR(Q5 vs. Q1) : 1.62, 95% CI: 1.07-2.45; p(trend) = 0.01), added fructose was associated with risk of small intestine cancer (HR(Q5 vs. Q1) : 2.20, 95% CI: 1.16-4.16; p(trend) = 0.009) and all investigated sugars were associated with increased risk of pleural cancer. In women, all investigated sugars were inversely associated with ovarian cancer. We found no association between dietary sugars and risk of colorectal or any other major cancer. Measurement error in FFQ-reported dietary sugars may have limited our ability to obtain more conclusive findings. Statistically significant associations observed for the rare cancers are of interest and warrant further investigation.

Milk consumption and bladder cancer risk: a meta-analysis of published epidemiological studies

Studies investigating the association of milk consumption with bladder cancer risk have reported inconsistent findings. We conducted a meta-analysis of published cohort and case-control studies to pool the risk estimates of the association between milk intake and bladder cancer. We quantified associations with bladder cancer using meta-analysis of odds ratio (OR) associated with the highest vs. the lowest category of milk intake using fixed- or random-effect models depending on the heterogeneity of effects among studies. Nineteen cohort and case-control studies were eligible for inclusion. High milk intake was significantly associated with decreased risk of bladder cancer (OR, 0.84; 95% CI, 0.71-0.97) when comparing the highest with the lowest category of milk intake. The inverse association was stronger in Asia (OR, 0.60; 95% CI, 0.40-0.81) than North America (OR, 0.89; 95% CI, 0.76-1.03), and no association was observed in Europe (OR, 1.05; 95% CI, 0.85-1.26). This relationship also varied significantly by specific dairy products. Our results suggest that milk may be related to the reduction of bladder cancer risk. Further studies need to clarify the biological mechanisms.

The association of fish consumption with bladder cancer risk: a meta-analysis

Background

The association between fish consumption and risk of bladder cancer has not been established yet. The results from epidemiological studies are inconsistent.

Methods

We conducted a meta-analysis of cohort and case-control studies on the relationship between fish intake and bladder cancer. We quantified associations with bladder cancer using meta-analysis of relative risk associated to the highest versus the lowest category of fish intake using random effect models. Heterogeneity among studies was examined using Q and I² statistics. Publication bias was assessed using the Begg's funnel plot.

Results

Five cohort and 9 case-control studies were eligible for inclusion. The combined relative risk showed that fish consumption was negatively, but not significantly, associated with a decreased risk of bladder cancer (relative risk, 0.86; 95% confidence interval, 0.61-1.12). In subgroup analyses, there was no evidence that study design, geographical region, case sample size, or exposure assessment substantially influenced the estimate of effects.

Conclusion

The overall current literature on fish consumption and the risk of bladder cancer suggested no association. Because of the limited number of studies, further well-designed prospective studies are needed to explore the effect of fish on bladder cancer.

Pathobiology and chemoprevention of bladder cancer

Our understanding of the pathogenesis of bladder cancer has improved considerably over the past decade. Translating these novel pathobiological discoveries into therapies, prevention, or strategies to manage patients who are suspected to have or who have been diagnosed with bladder cancer is the ultimate goal. In particular, the chemoprevention of bladder cancer development is important, since urothelial cancer frequently recurs, even if the primary cancer is completely removed. The numerous alterations of both oncogenes and tumor suppressor genes that have been implicated in bladder carcinogenesis represent novel targets for therapy and prevention. In addition, knowledge about these genetic alterations will help provide a better understanding of the biological significance of preneoplastic lesions of bladder cancer. Animal models for investigating bladder cancer development and prevention can also be developed based on these alterations. This paper summarizes the results of recent preclinical and clinical chemoprevention studies and discusses screening for bladder cancer.

Olive oil intake is inversely related to cancer prevalence: a systematic review and a meta-analysis of 13,800 patients and 23,340 controls in 19 observational studies

Dietary fat, both in terms of quantity and quality, has been implicated to cancer development, either positively or negatively. The aim of this work was to evaluate whether olive oil or monounsaturated fat intake was associated with the development of cancer. A systematic search of relevant studies, published in English, between 1990 and March 1, 2011, was performed through a computer-assisted literature tool (i.e., Pubmed). In total 38 studies were initially allocated; of them 19 case-control studies were finally studied (13800 cancer patients and 23340 controls were included). Random effects meta-analysis was applied in order to evaluate the research hypothesis. It was found that compared with the lowest, the highest category of olive oil consumption was associated with lower odds of having any type of cancer (log odds ratio = -0.41, 95%CI -0.53, -0.29, Cohran's Q = 47.52, p = 0.0002, I-sq = 62%); the latter was irrespective of the country of origin (Mediterranean or non-Mediterranean). Moreover, olive oil consumption was associated with lower odds of developing breast cancer (logOR = -0,45 95%CI -0.78 to -0.12), and a cancer of the digestive system (logOR = -0,36 95%CI -0.50 to -0.21), compared with the lowest intake. The strength and consistency of the findings states a hypothesis about the protective role of olive oil intake on cancer risk. However, it is still unclear whether olive oil's monounsaturated fatty acid content or its antioxidant components are responsible for its beneficial effects.

Chemoprevention in bladder cancer: What's new?

Bladder cancer is the sixth most common tumour in Canada and ranks eighth in terms of cancer mortality. Up to now, management of this condition relied mostly on surgical and intravesical treatments once the disease is established. Chemoprevention is an attractive option to prevent the disease in high-risk populations and may well reduce the costs related to its treatment. This review examines the available data on chemoprevention strategies in bladder cancer, with special emphasis on randomized controlled trials when available.

Intake of α-linolenic acid and other fatty acids in relation to the risk of bladder cancer: results from the New Hampshire case-control study

The role of dietary fat in bladder cancer aetiology is currently unclear due to few studies, equivocal findings and a lack of information on important dietary fatty acids. The aim of the present study was to investigate the association between the intake of major dietary fats and fatty acids and the risk of bladder cancer. A case-control study was conducted in New Hampshire, USA. Dietary data were collected from 322 cases and 239 controls, and OR and 95 % CI were calculated using unconditional logistic regression. Adjustment was made for potential confounders: sex, age, smoking status, pack-years smoked, cholesterol and energy intake. Statistically significant reduced odds of bladder cancer were observed for high intakes (highest quartile v. lowest quartile) of α-linolenic acid (ALA) (OR 0·26, 95 % CI 0·10, 0·65; P for trend = 0·01) and vegetable fat (OR 0·39, 95 % CI 0·18, 0·86; P for trend = 0·03). Borderline statistically significant reduced odds were detected for polyunsaturated fat (OR 0·43, 95 % CI 0·19, 0·98; P for trend = 0·07) and linoleic acid (OR 0·43, 95 % CI 0·19, 0·96; P for trend = 0·06). These fats and fatty acids were highly correlated and following adjustment for each other, the only potential inverse association to remain was for ALA. The present findings suggest that ALA may have a protective role against developing bladder cancer; however, further investigation and replication in other epidemiological studies are required. Future research should focus on the type, source and quantities of different dietary fatty acids consumed.

Dietary intake of micronutrients and the risk of developing bladder cancer: results from the Belgian case-control study on bladder cancer risk

OBJECTIVE

We aimed to investigate the effect of dietary intake of micronutrients that are metabolized and excreted via the urinary tract on bladder cancer risk.

METHODS

A semi-quantitative 322 item food frequency questionnaire (FFQ) was used to collect dietary data from 200 bladder cancer cases and 386 control subjects participating in the Belgian case-control study on bladder cancer risk. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression adjusting for age, sex, smoking characteristics, occupational exposures, and energy intake.

RESULTS

We observed a positive association between calcium intake and bladder cancer (OR: 1.77; 95% CI: 1.00-3.15; p-trend = 0.049) and increased odds, although not statistically significant, for highest tertile of phosphorus intake (OR: 1.82; 95% CI: 0.95-3.49; p-trend = 0.06). We identified possible modification of the effects of both calcium and phosphorus by level of magnesium intake. Increased odds of bladder cancer were also observed for participants with highest intake of phosphorus and lowest intake of vitamin D (OR: 4.25; 95% CI: 1.44-12.55) and among older participants with the highest intakes of calcium (OR: 1.90; 95% CI: 1.08-3.36) and phosphorus (OR: 2.02; 95% CI: 1.05-3.92).

CONCLUSION

The positive associations we observed between bladder cancer and intake of calcium and phosphorus require confirmation by other studies. The balances between inter-related micronutrients also warrant further examination.

Meat and components of meat and the risk of bladder cancer in the NIH-AARP Diet and Health Study

BACKGROUND

Meat could be involved in bladder carcinogenesis via multiple potentially carcinogenic meat-related compounds related to cooking and processing, including nitrate, nitrite, heterocyclic amines (HCAs), and polycyclic aromatic hydrocarbons (PAHs). The authors comprehensively investigated the association between meat and meat components and bladder cancer.

METHODS

During 7 years of follow-up, 854 transitional cell bladder-cancer cases were identified among 300,933 men and women who had completed a validated food-frequency questionnaire in the large prospective NIH-AARP Diet and Health Study. The authors estimated intake of nitrate and nitrite from processed meat and HCAs and PAHs from cooked meat by using quantitative databases of measured values. Total dietary nitrate and nitrite were calculated based on literature values.

RESULTS

The hazard ratios (HR) and 95% confidence intervals (CI) for red meat (HR for fifth quintile compared with first quintile, 1.22; 95% CI, 0.96-1.54; P(trend) = .07) and the HCA 2-amino-1 methyl-6-phenylimidazo(4,5-b)pyridine (PhIP) (HR, 1.19; 95% CI, 0.95-1.48; P(trend) = .06) conferred a borderline statistically significant increased risk of bladder cancer. Positive associations were observed in the top quintile for total dietary nitrite (HR, 1.28; 95% CI, 1.02-1.61; P(trend) = .06) and nitrate plus nitrite intake from processed meat (HR, 1.29; 95% CI, 1.00-1.67; P(trend) = .11).

CONCLUSIONS

These findings provided modest support for an increased risk of bladder cancer with total dietary nitrite and nitrate plus nitrite from processed meat. Results also suggested a positive association between red meat and PhIP and bladder carcinogenesis.

Dairy intake and the risk of bladder cancer in the Netherlands Cohort Study on Diet and Cancer

The authors examined the association between the intake of different dairy products and the risk of bladder cancer in 120,852 men and women aged 55-69 years participating in the Netherlands Cohort Study on Diet and Cancer. Dairy product intake was assessed in 1986 by using a 150-item food frequency questionnaire. The cohort was followed for 16.3 years, and 1,549 incident cases of bladder cancer were analyzed. Cox proportional hazards analysis was applied with a case-cohort approach by using the follow-up data of a random subcohort (n = 5,000). Multivariate hazard ratio estimates comparing the highest with the lowest quintile of total dairy intake were 1.01 (95% confidence interval (CI): 0.81, 1.27; P(trend) = 0.68). A statistically significant association for fermented milk products was found only for the second quintile (median, 12 g/day) (hazard ratio = 0.71, 95% CI: 0.56, 0.91). Compared with nonconsumers, women with 25-75 g/day of butter consumption had a hazard ratio of 1.61 (95% CI: 1.03, 2.50; P(trend) < 0.01). No association was found with cheese, calcium, lactose, or nonfermented dairy intake. These results provide weak evidence that bladder cancer risk is inversely associated with low intake of fermented dairy products and suggest a positive association with butter intake in women.

Minerals and vitamins and the risk of bladder cancer: results from the New Hampshire Study

Objective

Although the effect of fruit and vegetables on the risk of bladder cancer has been widely studied, little is known about their micronutrient components. Our aim was to investigate associations between minerals and vitamins and bladder cancer.

Methods

A case–control study was conducted in New Hampshire, USA. Dietary data were collected from 322 cases and 239 controls using a 121-item food frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression adjusting for sex, age, smoking characteristics, and energy intake.

Results

The ORs (95% CI) for highest quartile versus lowest quartile for total intake of vitamin E was 0.66 (0.36–1.20; p trend = 0.09) and 0.49 (0.21–1.17; p trend = 0.13) for dietary phosphorus. The odds of bladder cancer for heavy smokers with the highest total intake of vitamin E, carotenoids, and niacin were 0.58 (0.34–0.99), 0.62 (0.36–1.09), and 0.66 (0.39–1.14), respectively. Higher total intakes of carotenoids, vitamin D, thiamin, niacin, and vitamin E were inversely related to bladder cancer risk among older individuals.

Conclusion

Our findings suggest further investigation of the effect of vitamin E, carotenoids, vitamin D, thiamin, and niacin on bladder cancer risk may be warranted. Future studies should focus on high risk groups such as heavy smokers and older individuals.

Dietary intake of vegetables and fruits and the modification effects of GSTM1 and NAT2 genotypes on bladder cancer risk

We analyzed the association between intakes of vegetables and fruits as defined by the U.S. Department of Agriculture pyramid food groups and bladder cancer risk using data collected in a large case-control study. The study included 884 histologically confirmed bladder cancer cases and 878 healthy controls matched to cases by age (+/-5 years), gender, and ethnicity. Significant inverse associations were observed for intakes of total vegetables, cruciferous vegetables, orange vegetables, dark green vegetables, and bladder cancer risk. Compared with those in the lowest quartile of total vegetable intake, the odds ratios for the 2nd, 3rd, and 4th quartiles of total vegetable intake were 0.84 [95% confidence interval (95% CI), 0.64-1.10], 0.71 (95% CI, 0.54-0.95), and 0.67 (95% CI, 0.50-0.90), respectively (P for trend = 0.004). Compared with those in the lowest quartile, those in the highest quartile of cruciferous vegetable intake had an odds ratio of 0.69 (95% CI, 0.52-0.92; P for trend = 0.001) and those in the highest quartile of orange vegetable intake had an odds ratio of 0.68 (95% CI, 0.52-0.91; P for trend = 0.006). Furthermore, the protective effect of cruciferous vegetables was more evident in subjects carrying GSTM1-null (odds ratio, 0.43; 95% CI, 0.25-0.73 for the 4th quartile of intake) and NAT2-slow genotypes (odds ratio, 0.56; 95% CI, 0.33-0.97 for the 4th quartile of intake). No association was observed for intakes of total fruits or citrus fruits. Our data strongly support that high vegetable consumption, especially cruciferous vegetable intake, may protect against bladder cancer and that genetic variants of GSTM1 and NAT2 may modify the association.

Nutrition, total fluid and bladder cancer

Bladder cancer is a major health concern for older males in Western populations. About 30 years ago there was a suggestion that nutrition may have a role in the aetiology of the disease. Although the literature has been accumulating since then, owing to heterogeneity between studies results have often been inconsistent and unclear. The aim of this paper was to present an updated summary of the scientific evidence on the association between nutrition, total fluid intake and bladder cancer. A search of computerized databases, PubMed, ISI, Embase and Cochrane Library, was conducted to identify all epidemiological studies published between 1966 and October 2007. The level of scientific evidence for the various nutritional factors and total fluid intake was ranked according to the number of studies reporting a statistically significant association and the existence of mechanistic evidence. The levels of association were based on a ranking of statistically significant relative risks. Fruit and yellow-orange vegetables, particularly carrots and selenium, are probably associated with a moderately reduced risk of bladder cancer. Citrus fruits and cruciferous vegetables were also identified as having a possible protective effect. Possible risk factors are salted and barbecued meat, pork, total fat, pickled vegetables, salt, soy products, spices and artificial sweeteners. No clear association could be determined for beef, eggs, processed meats and total fluid intake. In conclusion, specific fruit and vegetables may act to reduce the risk of bladder cancer. Future studies on bladder cancer should investigate the effect of food categorization, amount and gender.

Elevated NCOR1 disrupts a network of dietary-sensing nuclear receptors in bladder cancer cells

Increasingly invasive bladder cancer cells lines displayed insensitivity toward a panel of dietary-derived ligands for members of the nuclear receptor superfamily. Insensitivity was defined through altered gene regulatory actions and cell proliferation and reflected both reduced receptor expression and elevated nuclear receptor corepressor 1 (NCOR1) expression. Stable overexpression of NCOR1 in sensitive cells (RT4) resulted in a panel of clones that recapitulated the resistant phenotype in terms of gene regulatory actions and proliferative responses toward ligand. Similarly, silencing RNA approaches to NCOR1 in resistant cells (EJ28) enhanced ligand gene regulatory and proliferation responses, including those mediated by peroxisome proliferator-activated receptor (PPAR) gamma and vitamin D receptor (VDR) receptors. Elevated NCOR1 levels generate an epigenetic lesion to target in resistant cells using the histone deacetylase inhibitor vorinostat, in combination with nuclear receptor ligands. Such treatments revealed strong-additive interactions toward the PPARgamma, VDR and Farnesoid X-activated receptors. Genome-wide microarray and microfluidic quantitative real-time, reverse transcription-polymerase chain reaction approaches, following the targeting of NCOR1 activity and expression, revealed the selective capacity of this corepressor to govern common transcriptional events of underlying networks. Combined these findings suggest that NCOR1 is a selective regulator of nuclear receptors, notably PPARgamma and VDR, and contributes to their loss of sensitivity. Combinations of epigenetic therapies that target NCOR1 may prove effective, even when receptor expression is reduced.

Lycopene in cancer prevention and treatment

Dietary intake of lycopene is inversely associated with the risk of many cancers. Preclinical studies show that lycopene has potent in vitro and in vivo antitumor effects, suggesting potential preventive and therapeutic roles for the compound. However, clinical trials with lycopene have only recently been started, and available clinical data preclude firm conclusions with regard to its use in cancer prevention and treatment. Further mechanistic studies and randomized controlled clinical intervention trials with lycopene involving cancer patients are warranted.

Risk factors for bladder cancer

AIMS AND BACKGROUND

To summarize risk factors for bladder cancer, emphasizing the role of recently established associations and to present some ongoing debates on the issue.

METHODS

A systematic literature search was performed using MEDLINE database on bladder cancer risk factors between January 1985 and June 2006 and by detailed examination of the references of original articles, reviews and monographs retrieved.

RESULTS

Cigarette smoking is recognized as the main cause of bladder cancer and accounts for about 50% of cases in developed countries. A strong link exists between the amount and duration of cigarette smoking. A high risk of bladder carcinoma has been observed in workers exposed to some aromatic amines. Based on these and other occupational risks, it has been estimated that 5-10% of bladder carcinomas in industrialized countries were due to exposures of occupational origin. Infectious agents have a major influence on bladder cancer risks in the areas of the world where Schistosoma haematobium infestation is endemic. Other potential risk factors for bladder cancer are other urinary tract infections and drinking tap water with chlorination by-products or arsenic. Exposure to certain drugs, like cyclophosphamide used in chemotherapy and heavy consumption of phenacetin-containing analgesics, has been shown to cause bladder cancer in humans. Total fluid intake and high consumption of fruits and vegetables are probably associated with a small decrease in risk.

CONCLUSIONS

Avoidance of tobacco smoking and incriminated occupational exposures, habitual intake of fresh fruits and vegetables, and prevention and control of urinary tract infections should be recommended for bladder cancer prevention. Further studies are required to assess the role of genetic polymorphisms and their modifying effect of lifestyle risk factors for bladder cancer occurrence and to evaluate the benefit of bladder cancer screening, particularly in those at high risk.

A prospective study of fish, marine fatty acids, and bladder cancer risk among men and women (United States)

OBJECTIVE

To evaluate prospectively the association between intakes of fish, marine fatty acids, and bladder cancer risk in two ongoing cohorts, the Health Professionals Follow-up Study and the Nurses' Health Study.

METHODS

During 16 and 18 years of follow-up, 501 and 235 incident cases of bladder cancer were diagnosed among men and women, respectively. Cox proportional hazard models were used to estimate incidence rate ratios (RR) and 95% confidence intervals (CI) between fish intake and bladder cancer risk adjusting for age, total caloric intake, pack-years of cigarette smoking, and current smoking.

RESULTS

We observed no significant overall association between total fish intake and bladder cancer risk, even when we compared >/=1 servings of fish per day to fish intake </=1-3 servings per month. Among men, a statistically significant lower risk of bladder cancer was observed among men consuming fish or high marine fatty acid, after excluding the first 4 years of follow-up (MV RR = 0.60; 95% CI, 0.38-0.94, for >/=1 total fish servings per day compared to </=1-3 servings per month).

CONCLUSIONS

Overall, these findings suggest that fish intake is not likely to be appreciably associated with the risk of bladder cancer.