American Journal of Epidemiology Vol. 127, No. 6: 1179-1191
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
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DIETARY FACTORS AND THE INCIDENCE OF CANCER OF THE URINARY BLADDER
1NCIC Epidemiology Unit, Department of Preventive Medicine and Biostatistics, University of Toronto, Toronto, Ontario
2Department of Preventive Medicine and Biostatistics, University of Toronto, Toronto, Ontario
3Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec
4Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario
Reprint requests to Dr. Harvey A. Risch, NCIC Epidemiology Unit, McMurrich Building 3rd Floor, University of Toronto, 12 Queen's Park Crescent W.t Toronto, Ontario M5S 1A8, Canada
A case-control study of diet and bladder cancer was conducted during 1979–1982 in Edmonton, Calgary, Toronto, and Kingston, Canada. A total of 826 histologically verified cancer cases were individually matched by age, sex, and area of residence to 792 randomly selected population controls. Subjects were interviewed concerning their histories of exposure to a number of dietary factors, including table-top artificial sweeteners, low calorie foods and drinks, beverages containing caffeine or ethanol, and certain other food items. Also, subjects provided information on their past medical, occupational, and residential histories, in addition to their exposures to tobacco and other life-style factors. For the analysis, conditional logistic regression methods were used. Under adjustment for cumulative lifetime amount of cigarette smoking, the dietary factors, with little exception, were not associated with significant alteration of risk for bladder cancer. In particular, ever regular use of artificial sweeteners did not appear to be associated with increased risk, either among men (odds ratio = 0.95, p = 0.70) or among women (odds ratio = 1.15, p = 0.53). However, daily intake of cholesterol, calculated from reported frequencies of consumption of nine relevant food items, suggested a mild increase in risk; the odds ratio estimate of trend was 1.07/100 mg average daily intake (i.e., 1.075.5 = 1.45 for 550 mg cholesterol per day, as might be consumed in one egg; p = 0.009). A history of diabetes mellitus of onset after age 20 years also seemed to be associated with increased risk of bladder cancer (odds ratio = 1.65, p = 0.019), but this increase did not appear to be the result of use of insulin or other medications, or use of artificial sweeteners or low calorie foods. Thus, this study tends to confirm reports of a lack of association between use of artificial sweeteners and subsequent risk of bladder cancer.
alcohol drinking; bladder neoplasms; cholesterol; coffee; diabetes mellitus; diet; retrospective studies; sweetening agents
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