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Correspondence
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Volume 341:847-848 September 9, 1999 Number 11
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Fluid Intake and Bladder Cancer

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 by Michaud, D. S.
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To the Editor: Michaud et al. (May 6 issue)1 conclude that a high fluid intake is associated with a decreased risk of bladder cancer in men. An alternative explanation for the finding is that a high fluid intake results in decreased detection of bladder cancer.

Bladder cancer typically presents as gross or microscopic hematuria.2 Hematuria is detected by dipstick of urine or by microscopical examination of centrifuged urinary sediment. If urine is dilute, the chance of detecting hematuria decreases. Because the reported fluid intake correlated positively with urine volume in this cohort,3 study subjects in the fifth quintile of fluid . . . [Full Text of this Article]

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