1. EMBARGOED FOR RELEASE UNTIL May 15, 2011 AT 10:00 A.M.
Contact: Wendy Waldachs Isett, AUA
410-977-4770, wisett@AUAnet.org
SMOKING LINKED TO ADVANCED KIDNEY CANCER;
BLADDER CANCER DECLINES NOT SEEN IN RESPONSE TO SMOKING CESSATION
Washington, DC -- May 15, 2011– Two new studies that further examine the links between cigarette
smoking and urologic cancers were presented to reporters during a special press conference at the
Walter E. Washington Convention Center on May 15, 2011 at 10:00 a.m. during the 106th Annual
Scientific Meeting of the American Urological Association (AUA). The session will be moderated by Toby
Kohler, MD.
Cigarette Smoking Is Associated With Advanced Renal Cell Carcinoma (#1256): While cigarette smoking
is a recognized risk factor for renal cell carcinoma (RCC) , kidney cancer, researchers from Duke University
Medical Center in Durham, NC examined the relationship between smoking and tumor pathology. In a
retrospective review of patients undergoing surgery for RCC between 2000 and 2009, researchers found
that heavier smoking increases the likelihood of advanced disease with a dose dependent effect;
cessation reduced the risk of advanced disease. The study examined 845 patients. Current and former
smokers had advanced disease 1.5 to 1.6 times as much as non-smokers. Heavier smoking (longer
duration and exposure) was associated with advanced RCC. Quitting reduced the odds of advanced
disease by 9 percent per smoke-free decade.
Discordance Between Time Trends of Bladder Cancer Incidence And Cigarette Consumption in The US
(#1065): Researchers from the State University of New York Upstate Medical University in Syracuse
investigated the relationship between trends in bladder cancer incidence and cigarette consumption in
the United States. They discovered by examining data from the Surveillance, Epidemiology and End
Results (SEER) database that, while the rates of lung cancer in the U.S. dropped consistently with the per
capita consumption of cigarettes between 1973 and 2007, the rates of bladder cancer did not fall as
consistently.
They noted that the decrease of cigarette consumption might have decreased the incidence of bladder
cancer, but that this positive effect may have been masked by other factors contributing to a rise in
bladder cancer incidences over the last several decades.
“These two studies shed new insight into the role that smoking might have for two important urologic
cancers.” Dr. Kohler said. “For kidney cancer, it is true that kidney tumors are more often being detected
these days when they are smaller. However, smoking seems to confer a much greater risk that the cancer
may be more aggressive. Cessation of smoking seems to lower the risk. For bladder cancer on the other
hand, the decrease in smoking rates has not impacted the incidence to the same degree that it has for

2. lung cancer, suggesting that there may be other factors which are becoming more important for
development of the disease. ”
NOTE TO REPORTERS: Experts are available to discuss this study outside normal briefing times. To
arrange an interview with an expert, please contact the AUA Communications Office at the number
above or e-mail Communications@AUAnet.org.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the
American Urological Association is the pre-eminent professional organization for urologists, with more than 17,000
members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the
highest standards of urologic care by carrying out a wide variety of programs for members and their patients.
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3. 1256
CIGARETTE SMOKING IS ASSOCIATED WITH ADVANCED RENAL CELL CARCINOMA
Matvey Tsivian, Daniel Moreira, Jorge Caso, Vladimir Mouraviev, Thomas Polascik, Durham, NC
INTRODUCTION AND OBJECTIVES: Cigarette smoking is a recognized risk factor for renal cell carcinoma
(RCC) but little data is available on the association between smoking and RCC biology. Herein we
investigated the association between cigarette smoking and RCC stage in a large contemporary
multiethnic surgical cohort.
METHODS: Retrospective review of demographic, clinical and pathological data of patients undergoing
surgery for RCC between 2000-2009. Advanced RCC was defined as metastatic disease, pathological stage
â?¥T3 and/or lymph node involvement. Self-reported smoking history included smoking status, duration,
intensity, cumulative exposure and cessation. Patient and tumor characteristics were compared between
the groups by univariate and multivariate analyses.
RESULTS: Of the 845 eligible patients, 19.4% and 29.1% were current and former smokers; 207 (24.5%)
patients had advanced disease. In both univariate and multivariate analyses, smoking was consistently
associated with advanced RCC and cessation reversed the risk. Current and former smokers had a 1.5 and
1.6-fold increased odds of advanced disease. Heavier smoking (longer duration and exposure) was
associated with increased risk of advanced RCC. Durable cessation reduced the odds of advanced disease
by approximately 9% per smoking-free decade.
CONCLUSIONS: Cigarette smoking is an independent risk factor for advanced RCC. Heavier smoking
increases the likelihood of advanced disease with a dose-dependent effect. Durable smoking cessation
attenuated the risk of advanced disease. Given that cigarette smoking is among the few modifiable risk
factors for RCC, our results reinforce the importance of smoking cessation and encourage further
investigation of the association between smoking and RCC biology.
Source of Funding: none

4. 1065
DISCORDANCE BETWEEN TIME TRENDS OF BLADDER CANCER INCIDENCE AND CIGARETTE
CONSUMPTION IN THE US
Jack Cheng-Tsung Hou, Ching Y. Wang, Syracuse, NY
INTRODUCTION AND OBJECTIVES: Cigarette smoking is a major cause of cancer of bladder and lung. We
investigated the relationship between the trends in bladder cancer incidence and cigarette consumption
in the US.
METHODS: The incidences of bladder and lung cancers from 1973 to 2007 and the treatment of prostate
cancer from 1988 to 2007 were retrieved from SEER database. Smoking prevalence data were from the
American Lung Association. Data of adult (age >= 18 years) per capita consumption of cigarettes were
from the US Department of Agriculture.
RESULTS: The adult per capita
consumption of cigarettes has been in
the rise since 1900 and it peaked in
1963. It has gradually decreased 62%
from 1963 to 2006. The adult per
capita cigarette tar exposure has
decreased by more than 80% during
this period of time. The prevalence of
smoking in adults has decreased from
51.9% to 23.1% in men and 33.9% to
18.3% in women from 1965 to 2008.
The age-adjusted incidence of lung
cancer in men peaked in 1984 and it
has decreased by 31% since then. The
time trend of lung cancer in men was in concordance with the per capita consumption of cigarettes with
a lag time of about 20 years which reflects the latent period for the induction of this cancer. However,
there was a lack of concordance between the trends of bladder cancer incidence and cigarette
consumption in men (Fig. 1). The median ages at diagnosis for the cancer of bladder and lung were 73
and 71 years, respectively, suggesting that the latent periods for the induction of both cancers may be
similar. External beam radiation therapy (EBRT) of prostate cancer has been suggested to be associated
with bladder cancer. However, less than 0.3% of all bladder cancers may be due to EBRT and it might only
marginally change bladder cancer incidence. The time trends of bladder and lung cancers in women were
not in concordance with per capita consumption of cigarettes.
CONCLUSIONS: As expected, the decrease of cigarette consumption is accompanied with the decrease of
lung cancer incidence in men. The stable trend of bladder cancer incidence is in discordance with
cigarette consumption. The decrease of cigarette consumption might have decreased the incidence of
bladder cancer, but this effect might be masked by other environmental factors that might have
increasingly contributed to this malignancy during the past several decades.
Source of Funding: None