Johansson S L, Cohen S M
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-3135, USA.
Semin Surg Oncol. 1997 Sep-Oct;13(5):291-8. doi: 10.1002/(sici)1098-2388(199709/10)13:5<291::aid-ssu2>3.0.co;2-8.
The incidence of bladder cancer continues to increase, with an estimated 53,000 new cases diagnosed in the United States in 1996-90% of which are transitional cell carcinomas. The male-to-female ratio is 3:1. A number of etiological factors are associated with the development of bladder cancer, but in industrialized countries, cigarette smoking is the most important. Specific chemicals have also been identified as causing bladder cancer, as have a number of occupational exposures to less well-defined specific agents. Treatment with cytostatic drugs, especially cyclophosphamide, is associated with increased risk of bladder cancer, as is treatment with radiotherapy for uterine cancer. In developing countries, especially in the Middle East and parts of Africa, infections with members of the genus Schistosoma are responsible for a high incidence of bladder cancer-75% of which are squamous cell carcinomas. Arsenic has been indicated as a bladder carcinogen in Argentina, Chile, and Taiwan. The reason for the high incidence of urinary tract cancer in individuals suffering from Balkan nephropathy has yet to be determined. A careful history of patients with bladder cancer is an important and useful process in helping to identify causal factor and, in more than one-half the cases, a known relationship is found. Bladder cancer is a potentially preventable disease, with a significant morbidity and mortality in many parts of the world.
膀胱癌的发病率持续上升，1996年美国估计有53000例新发病例，其中90%为移行细胞癌。男女比例为3:1。多种病因与膀胱癌的发生有关，但在工业化国家，吸烟是最重要的因素。特定化学物质以及一些不太明确的特定职业暴露也被确定可导致膀胱癌。使用细胞抑制药物，尤其是环磷酰胺治疗，以及子宫癌放疗均与膀胱癌风险增加有关。在发展中国家，特别是中东和非洲部分地区，血吸虫属感染导致膀胱癌高发，其中75%为鳞状细胞癌。在阿根廷、智利和台湾，砷已被确认为膀胱致癌物。巴尔干肾病患者尿路癌高发的原因尚未确定。仔细了解膀胱癌患者的病史对于确定病因非常重要且有用，在一半以上的病例中能发现已知的关联。膀胱癌是一种潜在可预防的疾病，在世界许多地区都有显著的发病率和死亡率。
