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Aetiology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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No single causative factor is identifiable in the majority of cases. In others, there may be an association with:

  • cigarette smoking - by itself, is associated with a 2-fold increased risk. Thought to be due to urinary excretion of inhaled carcinogens. Smoking may act synergistically with other risk factors.

  • occupational exposure to carcinogens widely used in the rubber, cable, textile and printing industries. For example,beta naphthylamine, benzidine, 4-diphenylalinine, and auramine and magenta dyes. Such exposure can be proven in only a small proportion of patients. There may be a latent period of 15-20 years. The bladder is particularly vulnerable as it exposed to urine for longer than other parts of the urinary tract.

  • drugs - e.g. phenacetin, aspirin, cyclophosphamide.

  • fungal toxins in Balkan nephropathy

  • endogenous carcinogens - e.g. nitrosamines, tryptophane metabolites (aminophenols)

  • squamous cell carcinoma is associated with chronic irritation and squamous metaplasia due to bladder stones or schistosomiasis. The latter is the main cause of bladder cancer worldwide.

  • adenocarcinoma may develop in peristent urachal remnants

  • adenocarcinoma or squamous carcinoma may be associated with bladder exstrophy

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