OBJECTIVE: Haute Normandie is characterized by the presence of a large number of industries likely to have exposed their employees to a risk of bladder cancer. The objective of the study performed by Assurance Maladie (national health insurance) and Réseau d'Onco-Urologie de Haute Normandie (ROUHN) (Haute Normandie Urological Oncology Network) was to describe the epidemiological characteristics of bladder cancers and to estimate the proportion of potentially work-related cancers.
MATERIAL: A questionnaire elaborated for the study and comprising demographic, clinical, environmental and occupational data was completed for all patients in whom exemption of co-payment for bladder cancer was requested in 2003.
RESULTS: The population comprised 258 patients with a mean age of 70.4 years. The sex-ratio was five males for one female. Tumours were diagnosed at an early stage: 73.9% of superficial tumours and 26.1% of invasive lesions. 72.1% of subjects were current smokers or ex-smokers (mean of 32 packet-years). Among the 41% of occupationally exposed subjects, 47.2% were mainly exposed to polycyclic aromatic hydrocarbons, 27.4% to diesel smoke and 17.9% to aromatic amines. Based on a multidisciplinary consultation, 14.7% of patients (n = 38) were considered to be eligible for an occupational disease declaration.
CONCLUSION: This study demonstrated that the incidence of occupational bladder cancers is underestimated. The urologist plays an essential role in the recognition of all risk factors of bladder cancer, as a history of smoking does not exclude the possibility of an occupational cause.