Two recently published papers find little association with alcohol consumption and bladder cancer. In the first study, researchers reviewed the influence of nutrition and lifestyle on bladder cancer incidence and recurrence and summarised food items, diets and lifestyle practices that physicians may wish to prioritise for discussion with their patients. The study results suggest an association between bladder cancer incidence and several food items including meat, milk products and oil. Micronutrient deficiency is associated with bladder cancer risk; however, it remains unclear if micronutrient supplementation can modify bladder cancer incidence. Total fluid intake, alcohol, coffee and tea seem to have no influence on bladder cancer incidence. There is weak evidence that stress, anxiety and lack of sleep may increase the risk of developing bladder cancer, whereas exercise may reduce the risk of dying from it. The authors conclude that several dietary items and life styles are associated with bladder cancer incidence and recurrence. However, besides smoking cessation, there is no evidence that a certain diet or lifestyle can decrease bladder cancer incidence. Source: Prevention of bladder cancer incidence and recurrence: nutrition and lifestyle. Fankhauser CD, Mostafid H. Curr Opin Urol. 2018 Jan;28(1):88-92. doi: 10.1097/MOU.0000000000000452.
Authors of the second study state that the association between alcohol consumption and bladder cancer risk has been insufficiently investigated in East Asian populations, who frequently have the inactive enzyme for metabolising acetaldehyde. Given that acetaldehyde associated with alcohol consumption is assessed as a carcinogen, consideration of differences in acetaldehyde exposure would aid accuracy in assessing the bladder cancer risk associated with alcohol consumption. The researchers conducted a population-based cohort study in Japan of 45,649 men and 50,266 women, aged 40-69 years to examine this association, including information on the flushing response as a surrogate marker of the capacity of acetaldehyde metabolism. During follow up from 1990 through 2012, 354 men and 110 women were newly diagnosed with bladder cancer. No significant association between alcohol consumption and bladder cancer risk was observed in the overall analysis. Among male flushers, HRs were 1.04 (95% CI 0.70-1.54), 1.67 (1.16-2.42), 1.02 (0.62- 1.67) and 0.63 (0.33-1.20) for alcohol consumption of 1-150, 151-300, 301-450, > 450 g/week of pure ethanol compared with non- and occasional drinkers, respectively, indicating an inverted U-shaped association between alcohol consumption and bladder cancer risk. In contrast, no significant association was identified among male non-flushers. The researchers say that the marginally significant interaction between alcohol consumption and the flushing response may support their hypothesis that acetaldehyde derived from alcohol consumption is associated with bladder cancer risk, but evidence for this association was not found in this study. A prospective study considering polymorphisms of genes involved in acetaldehyde metabolism is warranted the authors comment.
Source: Masaoka H; Matsuo K; Sawada N; Yamaji T; Goto A; Shimazu T; Iwasaki M; Inoue M; Eto M; Tsugane S, “Alcohol consumption and bladder cancer risk with or without the flushing response: the Japan Public Health Center-based prospective study”, International Journal of Cancer, Vol 141, No 12, 2017, pp2480-2488.