Physicians play critical role in ensuring bladder cancer patients understand link between smoking, their disease

At least half of bladder cancer cases diagnosed in the United States are the result of cigarette smoking. Bladder cancer is the second most common tobacco-related malignancy, a fact that is not well known even among bladder cancer surgeons, let alone the general public. Quitting smoking after cancer diagnoses can prolong survival, improve cancer prognoses, and decrease the risk of developing second cancers.

"For people who are smoking at the time of a cancer diagnosis, the first step in wanting to quit is knowing that smoking caused the cancer and that continuing to smoke will result in additional harm," said Jeffrey Bassett, MD, MPH, of the University of California, Los Angeles. He and his colleagues designed a study to characterize patients' knowledge of the link between tobacco use and bladder cancer risk, and to assess the impact that different sources of information have on patients' knowledge and beliefs regarding the cause of their bladder cancer.

The researchers surveyed a random sample of 790 bladder cancer survivors diagnosed between 2006 and 2009 in California. Sixty-eight percent had a history of tobacco use, and 19 percent were active smokers at the time of diagnosis. Tobacco use was the most cited risk factor for bladder cancer, with active smokers more knowledgeable than former or never smokers (90 percent versus 64 percent versus 61 percent). Urologists were patients' predominant source of information, cited most often by active smokers (82 percent). Calculations revealed that active smokers had a 6.37 times greater likelihood than never smokers of acknowledging tobacco use as a risk factor for bladder cancer, and smokers who named the urologist as their information source had a 2.80 times greater likelihood of believing tobacco use caused their cancer.

The study is the first to establish that informed bladder cancer patients readily accept that their smoking caused their cancer, debunking the myth that smokers refuse to acknowledge the negative health consequences of their tobacco use, according to Dr. Bassett. "Our findings also highlight the importance of the diagnosing physician in making sure that their patients are aware of the role that smoking played in their new cancer diagnosis. Patients who have this knowledge are better equipped to use the cancer diagnosis as motivation for quitting smoking, thereby improving their odds of survival."