blasenkrebs ursachen

[darline]

Sehr geehrter Herr Professor Wust,

ich möchte gerne wissen, ob der Blasenkrebs häufiger bei bestimmten Berufsgruppen, wie zum Beispiel Winzern (Pestizid-Einsatz), auftritt.

Vielen Dank und freundliche Grüße
Darline W.

[Prof. Wust]

RE: blasenkrebs ursachen


Nein, so einfach ist es nicht. Der einzige wirklich gesicherte und erhebliche Risikofaktor ist das Rauchen. Andere karzinogene Substanze, die früher in der Industrie aufgetreten sind, sind aro-matische Amine und Benzidin. Diese sind inzwischen längst reduziert worden. Grundsätzlich können alle möglichen Umweltfaktoren, soweit sie über die Niere ausgeschieden werden, einen Einfluß haben. Aber der Nachweis wäre im einzelne zu führen, ist schwierig und wird gering ein-geschätzt (wenige Prozent). Ihre Frage ist vermutlich bisher nicht untersucht worden. Der Nachweis kann vielleicht im Einzelfall geführt werden. Für eine größere Zahl wird es schwierig, u.a. auch weil wir in Deutschland kein richtiges Krebsregister haben. Die beiliegenden Zusam-menfassungen sollen Ihnen ein paar Punkte aufzeigen.

Epidemiology and etiology of bladder cancer.
AU: Johansson,-S-L; Cohen,-S-M
AD: Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-3135, USA.
SO: Semin-Surg-Oncol. 1997 Sep-Oct; 13(5): 291-8
AB: 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 occupatio-nal 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 ra-diotherapy 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 can-cer is a potentially preventable disease, with a significant morbidity and mortality in many parts of the world.

Towards causal inference in occupational cancer epidemiology--II. Getting the count right.
AU: Veys,-C-A
AD: School of Postgraduate Medicine and Biological Sciences, University of Keele, North Staf-fordshire Hospital Centre, Hartshill, Stoke-on-Trent, U.K.
SO: Ann-Occup-Hyg. 1993 Apr; 37(2): 181-9
AB: This second paper in the series assessing causal inference in occupational cancer epide-miology highlights the importance of using the right data sources when examining the association between exposure and tumour incidence in groups of workers. Using the wrong ones can lead to omissions which become insidious and cumulative during a long-term follow-up study, often extending over several decades. The main cause is the changing survival pattern of some cancers and it is a new and important factor to be taken into account. This was illustrated during an in-depth study of an excess of bladder cancer at a large tire factory, where the workforce was exposed to beta-naphthylamine-contaminated antioxidants used in processing. At first the study was confined to a mortality analysis using death certificates to identify those whose underlying cause of death was bladder cancer [International Classification of Diseases (8th Rev.), No. 188]. It soon became apparent, however, that several cases had outlived the study end-date, or had died of an unrelated cause, often with bladder cancer not being mentioned anywhere on the death certificate. The study was then changed also to include morbidity (incidence) data using cancer registration. Between 1946 and 1949 some 2090 men were exposed to two antioxidants contaminated with about 0.2% of beta-naphthylamine. Altogether there were 45 bladder tumours relevant to this 'at risk' group, whereas only 24.8 were expected at the national incidence rates (P < 0.001), which clearly reflects the group's exposure to a recognized bladder carcinogen.(ABSTRACT TRUNCATED AT 250 WORDS)