Bladder Cancer Coverage from Every Angle

Are Lebanese and Jordanian Populations at Higher Risk for Bladder Cancer?

By: Myles Starr
Posted: Thursday, September 16, 2021

Smoking cigarettes and waterpipes is popular in Lebanon and Jordan and on the rise. Environmental exposure to chemicals and second-hand smoke are risk factors for bladder cancer in both populations. Despite a lack of studies connecting bladder cancer and waterpipe use, Ali Shamseddine, MD, of the American University of Beirut Medical Center, Lebanon, and colleagues noted in the Journal of Smoking Cessation that “risk of cancer [from waterpipe use] is either due to elevated levels of carcinoembryonic antigen or to genotoxic and clastogenic components in the waterpipe use smoke.”

From January 2017 to January 2019, data were collected from two groups of adults with bladder cancer: 274 patients at The American University of Beirut Medical Center) and 158 patients from the King Hussein Cancer Center in Amman; of the 235 Lebanese patients, most were male (85.8% vs. 14.2% female). Patients answered questions about lifestyle, personal and family medical histories, smoking habits, and exposure to environmental hazards. 

Among Lebanese respondents, 34.3% were current smokers, and 46.7% were past smokers (72% heavy smokers). In contrast, 43% of Jordanian patients reported being current smokers, and 43% of Jordanian patients reported being past smokers (49.3% heavy smokers.) In the Lebanese cohort, 70.7% of patients were secondhand smokers, compared with 48.6% of Jordanian patients. Among Lebanese respondents, 34.3% were exposed to a least one environmental carcinogen unrelated to smoking, versus 48.1% in the Jordanian cohort.

Despite concerns over waterpipe smoking, less than 5% of smokers in each population were found to be exclusive waterpipe smokers. But more research is needed to establish links between waterpipe smoking and bladder cancer. In both countries, an increased prevalence of all types of smoking is cause for concern, and better antismoking policies are needed, noted the authors.

Disclosure: The study authors reported no conflicts of interest.

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