According to research, about half of all bladder cancer cases diagnosed in the United States are the result of cigarette smoking. The disease is the second most common tobacco-related malignancy, a fact that is not well known among the general public. “Quitting smoking after being diagnosed with cancer can prolong survival, improve prognosis, and decrease the risk of developing second cancers,” says Jeffrey C. Bassett, MD, MPH. “Ensuring that patients are aware of the relationship between smoking and bladder cancer is paramount to their diagnosis being a ‘teachable moment’ to quit.”

Few studies have looked at tobacco use knowledge and attribution of cause in patients with newly diagnosed bladder cancer. In a study published in Cancer, Dr. Bassett and colleagues sought to characterize patients’ knowledge of the link between tobacco use and bladder cancer risk using 2006-2009 data obtained from 790 respondents from the California Cancer Registry. The authors also looked at the impact of different sources of information on patients’ knowledge and beliefs regarding the cause of their bladder cancer.

Degrees of Knowledge

The study found that 68% of patients had a history of tobacco use, and 19% were active smokers when they were diagnosed with bladder cancer. Tobacco use was the most cited risk factor for bladder cancer, but active smokers were more knowledgeable on this association than former or non- smokers (90% vs 64% vs 61%, respectively). “Urologists also played a critical role in ensuring patients’ knowledge of the connection between smoking and bladder cancer,” Dr. Bassett says. The study showed that urologists were patients’ predominant source of information and were cited most often by active smokers (82%). Information from urologists commonly helped patients accurately identify smoking as a cause of bladder cancer.

Important Implications

“Our findings highlight the importance of physicians making sure that patients are aware of the role that smoking played in their new bladder cancer diagnosis,” says Dr. Bassett. “Patients who have this knowledge are better equipped to use their cancer diagnosis as motivation for quitting smoking, thereby improving their odds of survival.” He adds that informed bladder cancer patients readily accepted that smoking caused their cancer, debunking the previously held belief that smokers refuse to acknowledge the negative health consequences of their tobacco use.

In addition to bladder cancer, seventeen different types of cancer are now linked to tobacco use, according to Dr. Bassett. “Only two of these—lung cancer and cancer of the head and neck—are fairly well known to the general public. For individuals diagnosed with one of the lessor-known tobacco-related cancers, physicians again must ensure that their patients are aware of the role that smoking played in their diagnosis.”