Alert over smoking link to bladder cancer

Prof Robert Jones wants to raise awareness of disease diagnosed in 830 people each year in Scotland. Photograph: University of Glasgow

Robert Jones, Professor at the Glasgow Institute of Cancer Sciences, said the link with smoking had gone largely unrecognised.

About 830 people a year are diagnosed with bladder cancer in Scotland and smoking is the main avoidable risk factor. It is linked to an estimated 37 per cent of cases in the UK.

Despite this, the illness hardly features in anti-smoking campaigns.

The World Congress on Bladder Cancer took place last week in Edinburgh, where a range of treatment options were discussed.

The ATLANTIC trial, funded by Cancer Research UK, is being run by Professor Jones and his team.

He said: “Bladder cancer is primarily smoking related, so we predict in the coming years the relative mortality rate will come down.

“But it looks like we’re still to hit the peak rate in women. We’re talking about women who started smoking 40-50 years ago. At that time there were many more males than females smoking and the women took up smoking later, so we’re now coming to the peak of the smoking-related cancer wave for females, which is already on the downslope for men.

He added: “People always think of lung cancer in association with smoking. It is a much commoner disease than bladder cancer.

“But remember, the function of the bladder is to store urine and one of the purposes of urine is to expel the poisons that are extracted from the body. If you smoke then the carcinogens that are absorbed into the blood get filtered out into the urine and sit there in the bladder. Thereby they can cause bladder cancer.”

It is estimated that 42 per cent of bladder cancer cases each year in the UK are linked to lifestyle and other factors that are preventable.

Professor Jones said evidence suggests that people with bladder cancer experience a delay between the first symptoms and the final treatment.

He said: “There is some evidence that women are not referred early, largely because the symptoms of bladder cancer mimic symptoms of urinary tract infection, which is a common benign condition in women.

“The patient needs to be diagnosed early then treated promptly and it’s quite a complex pathway from initial presentation to specialist services.

“There are some new drugs coming through for the treatment of bladder cancer which have just been approved by the European Medicines Agency and will be coming up for funding decisions in NHS Scotland.”

Professor Linda Bauld, Cancer Research UK’s cancer prevention expert, based at the University of Stirling, said that smoking was “by far” the biggest preventable cause of bladder cancer in Scotland.

She added: “Scientists in Glasgow are looking at new ways to treat bladder and other urinary cancers through their work on the Cancer Research UK funded ATLANTIS trial. It aims to find out whether additional treatment can delay advanced forms of the disease coming back which could allow patients more time with family and friends.”