[Epidemiology of and risk factors for bladder cancer and for urothelial tumors].

Bladder cancer is the 5th most commonly diagnosed cancer in France, and most of cases occur in men and patients aged more than 65 years. The incidence and mortality are declining except in women in whom the incidence is increasing in recent years. Urothelial tumors of the upper urinary tract are less common but have similar aetiology to the bladder tumours. The recurrent aspect of superficial tumors and the morbidity of invasive tumors are an economic burden in the Western health systems. The two main risk factors for urothelial tumors are tobacco smoking and occupational exposure to chemicals carcinogens such as polycyclic aromatic hydrocarbons, nitrosamines, aromatic amines and arsenic. Other risk factors include urinary schistosomiasis, pelvic radiation therapy, the use of cyclophosphamide and probably diet and lifestyle factors. Prevention of bladder tumors is based on the control of these risk factors and individual screening in high-risk patients. Recognition as an occupational disease is an important part of the social management of patient, which is today inadequately performed.