Molecular epidemiology of bladder cancer: Known chemical causes of bladder cancer: Occupation and smoking

This article reviews the evidence concerning well known risk factors for bladder cancer, including several occupational exposures and tobacco smoking, and the underlying mechanistic processes. Emphasis is put on recent developments in the field of molecular epidemiology, including the study of carcinogen-DNA adducts in exfoliated bladder cells, of carcinogen-hemoglobin adducts, and of the modulating role played by genetically-based metabolic polymorphisms such as N-acetyltransferase. A model for bladder carcinogenesis in humans is offered. It is postulated that metabolic polymorphism plays a modulating role over the formation of macromolecule adducts, particularly at low doses of exposure.