Smoking, Early Menopause and Bladder Cancer

by WV Marshall

Yet another reason to snuff that cigarette permanently.

**Experiencing menopause before age 45 is associated with a higher risk of bladder cancer, research indicated. This higher risk was notable if the woman were a smoker. **

The study, which looked at health outcomes of more than 220,000 U.S. Nurses, was presented during the European Association of Urology congress in Barcelona. American and European scientists studied the medical histories of nurses enrolled in Nurses’ Health Study I and II, which followed health outcomes of the nurses since 1976.

The scientists found that women who went into menopause before the age of 45 were 45 percent more likely to have bladder cancer than those who went into menopause after 50. If these women experiencing early menopause had smoked, the risk of bladder cancer was 53 percent greater than women who had menopause at a later age.

Around one woman in 20 women undergoes early menopause before the age of 45; the average age at menopause is 51 in developed countries.

“We found that smoking women who experienced menopause before they were 45 years old had a greater risk of bladder cancer. Smoking remains the most important risk factor for bladder cancer,” lead researcher Dr. Mohammad Abufaraj said.

“Our data also revealed that it is unlikely that female factors such as age when periods begin, number of pregnancies, oral contraceptive use or the use of hormone replacement therapy are associated with bladder cancer risk. Smoking is associated with earlier age at menopause thereby further increasing the risk of developing bladder cancer.”

** Abufaraj said the study indicated that when menopause begins at an earlier age, the risk of bladder cancer increases.**

“Our primary interpretation is that a factor like smoking, which is known to correlate with earlier age at menopause, remains of grave concern as the main cause of in bladder cancer,” he said. “It reinforces the warning that smoking really is harmful in ways that we might not have easily imagined.”

Arnulf Stenzl, chairman EAU scientific congress committee and who was not involved in this research, said this long-term study demonstrated “smoking clearly sticks out as the underlying reason for the increased incidence of bladder cancer.”

“However, we need to remain open to other factors causing bladder cancer, such as hormonal changes leading to an earlier menopause; this work indicates that these changes may themselves be a result of long term nicotine exposure,” Stenzl said.

The same research team previously found that smoking has “a dose-response relationship” with prognosis in both early and advanced bladder cancer, European Association of Urology said. Cigarette consumption degrades outcomes, such as response to therapy and mortality. Once smoking cessation occurs, it takes a decade for the risks return to the same levels as non-smokers.

EAU released information about the study. (https://eurekalert.org/pub_releases/2019-03/eaou-emi031319.php)