Epidemiology of bladder cancer]

The urinary bladder cancer mortality varies in different countries. The highest rates are noted in Denmark, UK, Belgium and Italy, the lowest rates in Japan, Singapore and Venezuela. The mortality rates are increasing for both males and females. In France, the highest rates are observed in the South of France contrary to other cancer sites. The highest incidence rates are observed in Europe, in USA and in some countries of Africa. In these same areas, the rates are higher for males and are increasing with time. The mortality is high in the first years after diagnosis. The five-year relative survival rates are 41%, for males and 35% for females. Tobacco, and especially cigarettes, is a well known risk factor. A dose effect relation appears to exist. The occupational risk factors are potentiated by tobacco and modifications are noted and are in relation with new factors. Ground coffee is associated with urinary bladder cancer and appears to be a co-carcinogenic factor with tobacco. Some drugs, such as antimitotics, phenacetin, radiation and urinary bilharziosis, are etiological factors of this cancer. The role of artificial sweeteners, alcohol and nutrition is less well documented.