The role of genetic factors in bladder cancer.

The etiology of bladder cancer with regard to environmental factors is well known, but little attention has been focused on the role of genetic factors. The international variation in bladder cancer rates leaves open the question of whether this can be accounted for solely as the result of the differential distribution of environmental factors. In this review, the diverse literature on the potential role of genetic factors in bladder cancer is summarized in four categories: 1) familial aggregation, 2) genetic polymorphisms, 3) the N-acetyltransferase phenotype, and 4) activated oncogenes and chromosomal changes. The role of genetic factors has not been conclusively ascertained, but it appears that two different patterns of genetic involvement can be identified: a Mendelian pattern of autosomal dominant inheritance that accounts for a very small number of cases, and a multifactorial, probably polygenic, pattern involving genetic and environmental interaction. More research is needed to corroborate these findings and assess their significance.