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American Journal of Epidemiology Vol. 128, No. 5: 1027-1037
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health

research-article

RACIAL DIFFERENCES IN BLADDER CANCER RISK: A CASE-CONTROL STUDY

CATHERINE SCHAIRER1,, PATRICIA HARTGE1, ROBERT N. HOOVER1 and DEBRA T. SILVERMAN2

1Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health Bethesda, MD
2Biostatistics Branch, National Cancer Institute, National Institutes of Health Bethesda, MD

Reprint requests to Catherine Schairer, Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Executive Plaza North, Room 443, Bethesda, MD 20892

To determine why the incidence rate of transitional cell bladder cancer in whites in the United States is approximately twice that in blacks, the authors examined data from a large population-based case-control study of bladder cancer conducted in 1978 involving 2,982 cases and 5,782 controls. The relative risk of transitional cell carcinoma for whites compared with blacks was 1.9 before adjustment for the major bladder cancer risk factors, whereas after adjustment for cigarette smoking and occupation it was 1.6 (95% confidence interval (Cl): 1.3–2.1). Further adjustment for other risk factors, including history of a bladder infection and a family history of urinary tract cancer, did not after this estimate. The elevated risk of whites compared with blacks was limited, however, to cases whose disease was confined to the mucosa and submucosa. Among cases whose disease had extended to the bladder musculature or beyond, whites were at slightly reduced risk compared with blacks. This suggests that whites may be diagnosed with conditions that go undetected in blacks but that are unlikely as a group to progress to more extensive disease. Because of the population-based nature of the study, it was possible to determine that if bladder cancer incidence among whites of both sexes was reduced to the level among blacks, total incidence in the United States would fall by 36 per cent.

adenocarcinoma; blacks; bladder neoplasms; carcinoma; squamous cell; carcinoma; transitional cell; whites


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