Introduction
The American Cancer Society estimates that in 1996 there will be 52,900 new cases of bladder cancer and 11,700 deaths from bladder cancer.1 Bladder cancer is the fifth most common neoplasm and the twelfth leading cause of cancer death. Males are affected three times more frequently than women.
Numerous chemicals are suspected bladder cancer forming agents, however, only cigarette smoking and occupational exposure to a certain class of organic chemicals called aromatic amines (beta-naphthylamines, xenylamine, 4-nirtobiphenyl, benzidine) are well-established risk factors.2 Bladder cancer due to aromatic amine exposure has been documented in the textile, leather, rubber, dye, paint, hairdressing, and organic chemical industries. A period of 5 to 50 years may follow the exposure of carcinogenic agents and the diagnosis of bladder cancer by a physician . The more one smokes the greater the risk of bladder cancer; in most cases the risk from smoking increases the chance of bladder cancer two- to five-fold. No direct relationship between secondhand smoke inhalation and bladder cancer has been established.
The most common clinical presentation is blood in the urine or hematuria. Usually this is painless and the blood may be visible to the naked eye (gross hematuria) or can be seen only under the microscope (microscopic hematuria). Frequently the diagnosis of bladder cancer is delayed because bleeding is intermittent or attributed to other causes such as urinary tract infection or blood thinners. However, a substantial proportion of these patients will have a significant problem such as kidney stones or tumors, urinary tract obstruction and bladder cancer.
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