The contemporary landscape of occupational bladder cancer within the United Kingdom: A meta-analysis of risks over the last 80 years

Bladder cancer (BC) is a common malignancy that arises through occupational carcinogen exposure. Here we analyse trends in UK to better understand contemporary occupational BC.

To profile the contemporary risks of occupational BC in the UK.

Systematic review using PubMed, Medline, Embase and Web of Science was performed in March 2016. We selected reports of British workers in which BC or occupation were the main focus, with sufficient cases or with confidence intervals (CI). We used the most recent data in populations with multiple reports. We combined odds ratios and risk ratios (RRs) to provide pooled RRs of incidence and disease specific mortality (DSM). We tested for heterogeneity and publication bias. We extracted BC mortality from Office of National Statistics death certificates. We compered across regions and with our meta-analysis.

We identified 25 articles reporting risks in 702,941 persons. Meta-analysis revealed significantly increased incidence for 12/37 and DSM for 5/37 occupational classes. Three classes had reduced BC risks. The greatest risk of BC incidence occurred in chemical process (RR 1.87 (1.50-2.34)), rubber (RR 1.82 (1.4-2.38)) and dye workers (RR 1.8, (1.07-3.04)). The greatest risk of DSM occurred in electrical (RR 1.49 (1.19-1.87)) and chemical process workers (RR 1.35 (1.09-1.68)). BC mortality was higher in the North of England, probably reflecting smoking patterns and certain industries. Limitations include the lack of sufficient robust data, missing occupational tasks and no adjustment for smoking.

Occupational BC occurs in many workplaces and the risks for incidence and DSM may differ. Regional differences may reflect changes in industry and smoking patterns. Relatively little is known about BC within British industry, suggesting official data underestimate the disease. This article is protected by copyright. All rights reserved.

BJU international. 2016 Jun 22 [Epub ahead of print]

Marcus G Cumberbatch, Ben Windsor Shellard, James Wf Catto

Academic Urology Unit, University of Sheffield, Sheffield., Office for National Statistics, Newport, Gwent, United Kingdom., Academic Urology Unit, University of Sheffield, Sheffield.