Fluid intake, micturition habits, associated medications and conditions as potential risk factors for bladder cancer

Unrestricted The urogenous-contact hypothesis proposes that the development of bladder cancer is associated with prolonged exposure to carcinogens in urine. To fully examine this hypothesis, this dissertation systematically addressed fluid intake, micturition habits, associated medical conditions, and medications in relation to risk of bladder cancer in the Los Angeles Bladder Cancer Case-Control Study.; Total fluid intake was not associated with risk of bladder cancer, but specific types of beverages had different influence on bladder cancer. Consumption of water and alcoholic beverages were associated with a reduced risk of bladder cancer, whereas consumption of coffee was associated with a slightly increased risk, especially among heavy drinkers. The alcohol-bladder cancer association was modified by genetic variations in glutathione S-transferases, and the coffee-bladder cancer association was modified by variations in N-acetyltransferase 2 and cytochrome P450 1A2.; This dissertation also examined the role of selected medical conditions and medications which have been shown to affect the intake of fluid and the frequency of urination. Women with a history of bladder infection had a lower risk of bladder cancer, while subjects with diabetes, heart attack, or gout exhibited a higher risk. A history of hypertension, and use of diuretics or antihypertensive drugs were not associated with bladder cancer; however, untreated hypertensive patients had a significantly reduction in bladder cancer risk compared to normotensive subjects, especially among men.; This dissertation also addressed the role of urination frequency on bladder carcinogenesis. The role of urination frequency was also addressed in this dissertation. Frequency of daytime urination seemed to exert its effect on bladder cancer depending on the substrate. The inverse associations between water intake, alcohol intake, and bladder cancer risk were modified by frequency of daytime urination with the reduction in risk confined to those who urinated more frequently. However, frequency of urination seemed not to play a role in the bladder infectionbladder cancer association. Nocturia was associated with an increased risk of bladder cancer among women.