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Previous Volume 340:1390-1397 May 6, 1999 Number 18 Next

	Full Text PDF Editorial by Jones, P. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Studies in animals have shown that the frequency of urination is inversely associated with the level of potential carcinogens in the urothelium. In humans, an increase in total fluid intake may reduce contact time between carcinogens and urothelium by diluting urinary metabolites and increasing the frequency of voiding. The data on fluid intake in relation to the risk of bladder cancer are inconclusive.

Methods We examined the relation between total fluid intake and the risk of bladder cancer over a period of 10 years among 47,909 participants in the prospective Health Professionals Follow-up Study. There were 252 newly diagnosed cases of bladder cancer during the follow-up period. Information on total fluid intake was derived from the reported frequency of consumption of the 22 types of beverages on the food-frequency questionnaire, which was completed by each of the 47,909 participants who were free of cancer in 1986. Logistic-regression analyses were performed to adjust for known and suspected risk factors for bladder cancer.

Results Total daily fluid intake was inversely associated with the risk of bladder cancer; the multivariate relative risk was 0.51 (95 percent confidence interval, 0.32 to 0.80) for the highest quintile of total daily fluid intake (>2531 ml per day) as compared with the lowest quintile (<1290 ml per day). The consumption of water contributed to a lower risk (relative risk, 0.49 [95 percent confidence interval, 0.28 to 0.86] for 1440 ml [6 cups] per day vs. <240 ml [1 cup] per day), as did the consumption of other fluids (relative risk, 0.63 [95 percent confidence interval, 0.39 to 0.99] for >1831 ml per day vs. <735 ml per day).

Conclusions A high fluid intake is associated with a decreased risk of bladder cancer in men.

Source Information

From the Departments of Nutrition (D.S.M., E.B.R., W.C.W., E.L.G.), Epidemiology (D.S., E.B.R., W.C.W., E.L.G.), and Biostatistics (D.S.), Harvard School of Public Health, Boston; the Channing Laboratory, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston (E.B.R., G.C.C., W.C.W., E.L.G.); and the Arthur G. James Cancer Hospital and Research Institute, Ohio State University, Columbus (S.K.C.).

Address reprint requests to Dr. Michaud at the Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115 or at hpdsm{at}gauss.bwh.harvard.edu.

Full Text of this Article

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Fluid Intake and Bladder Cancer
Goldstein M. R., Michaud D. S., Giovannucci E. L., Clinton S. K.
Extract | Full Text  
N Engl J Med 1999; 341:847-848, Sep 9, 1999. Correspondence

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