Section of Urology, University of Chicago Hospitals, Chicago, IL 60637, USA.
Urol Oncol. 2012 Mar-Apr;30(2):199-211. doi: 10.1016/j.urolonc.2011.10.010.
Approximately 50% of bladder cancer incidence in the United States has been attributed to known carcinogens, mainly from cigarette smoking. Following the identification of this important causative factor, many investigators have attempted to identify other major causes of bladder cancer in the environment. Genetic and epigenetic alterations related to carcinogenesis in the bladder have been linked to environmental and occupational factors unrelated to cigarette smoking and may account for a significant portion of bladder cancer cases in non-smokers. The interaction between genetics and exposures may modulate bladder cancer risk and influence the differing incidence, progression, and mortality of this disease in different genders and races. Comparative molecular studies are underway to measure the relative effects of environment and inheritance to account for observed differences in the epidemiology of bladder cancer. The use of geospatial tools and population-based data will offer further insight into the environmentally-linked causes of bladder cancer.
在美国，大约有 50%的膀胱癌发病率归因于已知的致癌物质，主要来自吸烟。在确定了这一重要的致病因素后，许多研究人员试图在环境中确定膀胱癌的其他主要病因。与膀胱癌发生相关的遗传和表观遗传改变与与吸烟无关的环境和职业因素有关，可能占非吸烟者膀胱癌病例的很大一部分。遗传和暴露之间的相互作用可能会调节膀胱癌的风险，并影响这种疾病在不同性别和种族中的发病率、进展和死亡率。正在进行比较分子研究，以衡量环境和遗传的相对影响，以解释膀胱癌流行病学中观察到的差异。使用地理空间工具和基于人群的数据将进一步深入了解与膀胱癌相关的环境原因。
