This recent study by Marc Diocera gives more weight to smoking being a major factor in bladder cancer illness.
Substantial changes in the prevalence of the principal kidney and bladder cancer risk factors, smoking (both cancers) and body fatness (kidney cancer), have occurred but the contemporary cancer burden attributable to these factors has not been evaluated. We quantified the kidney and bladder cancer burden attributable to individual and joint exposures and assessed whether these burdens differ between population subgroups. We linked pooled data from seven Australian cohorts (N = 367,058) to national cancer and death registries and estimated the strength of the associations between exposures and cancer using adjusted proportional hazards models. We estimated exposure prevalence from representative contemporaneous health surveys. We combined these estimates to calculate population attributable fractions (PAFs) with 95% confidence intervals (CIs), accounting for competing risk of death, and compared PAFs for population subgroups. During the first 10-year follow-up, 550 kidney and 530 bladder cancers were diagnosed and over 21,000 people died from any cause. Current levels of overweight and obesity explain 28.8% (CI = 17.3-38.7%), current or past smoking 15.5% (CI = 6.0-24.1%) and these exposures jointly 39.6% (CI = 27.5-49.7%) of the kidney cancer burden. Current or past smoking explains 44.4% (CI = 35.4-52.1%) of the bladder cancer burden, with 24.4% attributable to current smoking. Ever smoking explains more than half (53.4%) of the bladder cancer burden in men, and the burden potentially preventable by quitting smoking is highest in men (30.4%), those aged 2 standard alcoholic drinks/day (41.2%). In conclusion, large fractions of kidney and bladder cancers in Australia are preventable by behaviour change.
Smoking and obesity are leading risk factors for cancers of the kidneys and bladder. In many industrialized countries, however, the proportion of kidney and bladder cancers attributable to these factors relative to one another may be changing, owing to recent declines in smoking and increases in obesity prevalence. Here, analyses of contemporaneous exposure prevalence data show that in Australia, body fatness is surpassing smoking as the leading modifiable risk factor for kidney cancer burden. Overweight and obesity accounted for 28.8 percent of the country’s future kidney cancer burden. Meanwhile, 44.4 percent of future bladder cancers remain attributable to smoking.