吸烟在膀胱癌的发病和进展中的病因作用，以及泌尿科医生在戒烟中的责任
2009/07/30
目的：吸烟是一个膀胱癌已经确定的危险因素。作者对膀胱癌从发病到进展的全过程中吸烟暴露的影响进行特征化，并讨论加强吸烟对膀胱癌发病贡献的理解可以帮助泌尿外科医生与患者有效沟通及促进戒烟。
方法：对MEDLINE数据库中从1975～2007年的有关吸烟和膀胱癌关系的流行病学研究和相关文献进行回归性分析。
结果：吸烟在膀胱癌发病中参与了高达50%的致病病因，并且在膀胱癌的发病归因因素中吸烟占的比例可能还在增大。普通民众并不知晓吸烟和膀胱癌之间的这种关联，而临床医师在吸烟风险辅导教育方面做的工作不足。现已证实戒烟可以使得包括膀胱癌在内的许多吸烟相关疾病的风险降低，使戒烟者获益。医师提供的简单的咨询干预可能会触发起病人努力戒烟的动机。
结论：膀胱癌在病因上与吸烟相关而这种知识可能并不为患者所熟知。此外，戒烟可以降低膀胱癌的风险并可能降低浅表膀胱癌的的复发。泌尿外科医生对于患者吸烟风险的认识和鼓励患者戒烟负有重要的责任。
（张永明编译 刘国梁审校）
J Urol. 2008 Jul;180(1):31-37; discussion 37. Epub 2008 May 15
J Urol. 2008 Jul;180(1):31-37; discussion 37. Epub 2008 May 15
The causal role of cigarette smoking in bladder cancer initiation and progression, and the role of urologists in smoking cessation.
Strope SA, Montie JE.
Department of Urology, University of Michigan Health System, Ann Arbor, Michigan 48109-0330, USA.
PURPOSE: Cigarette smoking is a well established risk factor for bladder cancer. We characterize the changing impact of this exposure throughout the course of bladder cancer from incidence through progression. We also discuss how understanding the risk of bladder cancer attributable to smoking can help urologists effectively communicate with their patients and influence smoking cessation in their patients.
MATERIALS AND METHODS: A review using the MEDLINE database from 1975 through 2007 was performed to search for studies from the epidemiological and medical literature on cigarette smoking and bladder cancer.
RESULTS: Cigarette smoking accounts for up to 50% of all incident bladder cancer cases, an attributable fraction that may be increasing. The general public is not informed of the association between cigarette smoking and bladder cancer, and physicians do a poor job of counseling patients regarding this risk. Smoking cessation has proven beneficial in decreasing the risk of many smoking related illnesses, including bladder cancer. Simple physician interventions can be effective in triggering patient attempts at quitting smoking.
CONCLUSIONS: Bladder cancer is causally related to cigarette smoking but this knowledge may not be well disseminated to patients. Furthermore, cigarette smoking cessation decreases bladder cancer risk and may decrease the recurrence of superficial bladder cancer. Urologists have a vital role in influencing patient knowledge of their smoking risk and in encouraging smoking cessation.
PMID: 18485400 [PubMed - indexed for MEDLINE]
RESULTS: Cigarette smoking accounts for up to 50% of all incident bladder cancer cases, an attributable fraction that may be increasing. The general public is not informed of the association between cigarette smoking and bladder cancer, and physicians do a poor job of counseling patients regarding this risk. Smoking cessation has proven beneficial in decreasing the risk of many smoking related illnesses, including bladder cancer. Simple physician interventions can be effective in triggering patient attempts at quitting smoking.
CONCLUSIONS: Bladder cancer is causally related to cigarette smoking but this knowledge may not be well disseminated to patients. Furthermore, cigarette smoking cessation decreases bladder cancer risk and may decrease the recurrence of superficial bladder cancer. Urologists have a vital role in influencing patient knowledge of their smoking risk and in encouraging smoking cessation.
PMID: 18485400 [PubMed - indexed for MEDLINE]
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戒烟6个月后的主动脉反射波反应改善：一个前瞻性研究
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吸烟相关心血管风险：临床医生综述
