Urinary Bladder Cancer Risk Factors: A Lebanese Case-Control Study


Background: Bladder cancer is the second most incident malignancy among Lebanese men. The purposeof this study was to investigate potential risk factors associated with this observed high incidence.
Methods: Acase-control study (54 cases and 105 hospital-based controls) was conducted in two major hospitals in Beirut.Cases were randomly selected from patients diagnosed in the period of 2002-2008. Controls were convenientlyselected from the same settings. Data were collected using interview questionnaire and blood analysis. Exposuredata were collected using a structured face-to-face interview questionnaire. Blood samples were collected todetermine N-acetyltransferase1 (NAT1) genotype by PCR-RFLP. Analyses revolved around univariate, bivariateand multivariate logistic regression, along with checks for effect modification.
Results: The odds of havingbladder cancer among smokers was 1.02 times significantly higher in cases vs. controls. The odds of exposure tooccupational diesel or fuel combustion fumes were 4.1 times significantly higher in cases vs controls. The oddsof prostate-related morbidity were 5.6 times significantly higher in cases vs controls. Cases and controls showeddifferent clustering patterns of NAT1 alleles. No significant differences between cases and controls were foundfor consumption of alcohol, coffee, tea, or artificial sweeteners.
Conclusions: This is the first case-control studyinvestigating bladder cancer risk factors in the Lebanese context. Results confirmed established risk factorsin the literature, particularly smoking and occupational exposure to diesel. The herein observed associationsshould be used to develop appropriate prevention policies and intervention strategies, in order to control thisalarming disease in Lebanon.