Fluid intake and the risk of urothelial cell carcinomas in the European Prospective Investigation into Cancer and Nutrition (EPIC)

Abstract

Results from previous studies investigating the association between fluid intake and urothelial cell carcinomas (UCC) are inconsistent. We evaluated this association among 233,236 subjects in the European Prospective Investigation into Cancer and Nutrition (EPIC), who had adequate baseline information on water and total fluid intake. During a mean follow‐up of 9.3 years, 513 first primary UCC occurred. At recruitment, habitual fluid intake was assessed by a food frequency questionnaire. Multivariable hazard ratios were estimated using Cox regression stratified by age, sex and center and adjusted for energy intake, smoking status, duration of smoking and lifetime intensity of smoking. When using the lowest tertile of intake as reference, total fluid intake was not associated with risk of all UCC (HR 1.12; 95%CI 0.86–1.45, p‐trend = 0.42) or with risk of prognostically high‐risk UCC (HR 1.28; 95%CI 0.85–1.93, p‐trend = 0.27) or prognostically low‐risk UCC (HR 0.93; 95%CI 0.65–1.33, p‐trend = 0.74). No associations were observed between risk of UCC and intake of water, coffee, tea and herbal tea and milk and other dairy beverages. For prognostically low‐risk UCC suggestions of an inverse association with alcoholic beverages and of a positive association with soft drinks were seen. Increased risks were found for all UCC and prognostically low‐risk UCC with higher intake of fruit and vegetable juices. In conclusion, total usual fluid intake is not associated with UCC risk in EPIC. The relationships observed for some fluids may be due to chance, but further investigation of the role of all types of fluid is warranted.

Risk of Alcohol Consumption in Bladder Cancer: Case-Control Study from a Nationwide Inpatient Database in Japan

“…The fact that we studied Japanese patients, having weak genetic features on acetaldehyde detoxification as a whole, may explain why we found the risk. In addition, because we analyzed a large, nationwide dataset, the number of bladder cancer case was much larger than previous case-control studies and cohort studies (Murata et al 1996;Wakai et al 2004;Inoue et al 2005;Ros et al 2011), which provided efficient statistical power to detect the risk. Moreover, we tried to prevent possible confounding by simultaneous controlling for detailed information on smoking, occupational background, and comorbidity, as well as major patient baseline characteristics.…”

“…As the incidence of bladder cancer was low and the numbers of bladder cancer were small in previous large cohort studies, we performed a matched case-control study (Inoue et al 2005;Ros et al 2011). …”

Bladder cancer prevention

“…The results of epidemiological studies on the relationship between fluid intake and the risk of bladder cancer thus far are inconclusive [28][29][30][31][32].…”

“…The European Prospective Investigation into Cancer and Nutrition (EPIC), which studied the relationship between the quantity and type of consumed fluids and the risk of bladder cancer, however, failed to establish any correlation between the two variables [31]. Wang et el., on the other hand, showed that an increase in total fluid intake correlates with a 41% increase in the risk of disease [32].…”

“…The most frequently listed drinks include water, tea, coffee, and alcohol [28]. Studies thus far indicate the protective effects of water, tea, wine, and milk [28,31,32]. Data on coffee are inconclusive.…”