[Phenacetin, paracetamol and bladder cancer].

Every year great quantities of analgesics of various kinds are employed in Denmark. Among the preparations previously employed, considerable evidence has been found that phenacetin-containing combination analgesics can produce cancer in man while there is limited evidence that phenacetin alone can produce cancer. Combination analgesics containing phenacetin increase the risk of development of tumours in the renal pelvis. This is a rare form of tumour with certain etiological features in common with tumours of the bladder. It may appear probable that phenacetin also increases the risk of development of cancer of the bladder but review of the literature provides only limited evidence of this. The possible carcinogenic effect of paracetamol in man is only sparsely illustrated. No reports about an increased risk for cancer of the bladder are available. Phenacetin was withdrawn from the Danish market on 1.1.1985 on account of the suspected carcinogenic effect. Since 1977, the sale of paracetamol (acetaminophen) which is also a breakdown product of phenacetin has been increasing steadily.