E-cigarette use and the potential risk for bladder cancer
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The University of North Carolina at Chapel Hill, North Carolina, United States
Publication date: 2023-10-08
Corresponding author
Marc Bjurlin   

The University of North Carolina at Chapel Hill, North Carolina, United States
Tob. Prev. Cessation 2023;9(Supplement 2):A95
Use of electronic cigarettes (e-cigarettes) has rapidly increased despite unclear longitudinal health effects. Once thought to be a safer alternative to tobacco smoke, it is possible that e-cigarettes expose the user to similar carcinogenic byproducts during the vaping process, potentially placing users as risk for bladder cancer.

To characterize the institutional data, population weighted studies, as well as translational and basic science findings of e-cigarette use as it relates to the potential risk of bladder cancer.

Literature review.

Up to 8% of bladder cancer survivors use e-cigarettes. Cancer survivors commonly perceive e-cigarettes to be as much or more harmful than traditional cigarettes. Six carcinogens that have a known strong link to bladder cancer have been identified in the urine of e-cigarette users (pyrene, naphthalene, fluorene, phenanthrene, o-toluidine, and 2-naphthylamine). Untargeted metabolomics of the urine of e-cigarette users have demonstrated the cancer related biomarker Me-Fapy and genotoxic MNPB in the urine of e-cigarettes users at levels higher than non-user controls. Patterns in methylation appears to be altered in vaped mice within tumor suppressor genes (protocadherin gene cluster), potentially leading to gene silencing which may play a fundamental role in precipitating the development of bladder cancer.

Long-term implications of chronic urothelial exposure to urinary carcinogens of e-cigarette users are unknown and will require long-term follow-up. However, the current data and literature provides a useful scientific rationale to consider the carcinogenic-specific aspects of using e-cigarettes. The malignant potential of e-cigarettes for bladder cancer remains unknown and is likely less than that of combustible cigarettes.

The author has no conflicts of interest to disclose.
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