Dorgan et al., 1999

Female serum bank donors in Columbia, Missouri




Highest quartile of serum β-HCH


0.6 (0.3–1.3)

Hoyer et al., 1998

Female serum samples from Copenhagen City Heart Study




Highest quartile of serum β-HCH


1.36 (0.79–2.33)b

Case-Control Studies

Zheng et al., 1999

Breast adipose tissue from women in Connecticut




Highest quartile of serum β-BHC


0.6 (0.3–1.1)

Mussalo-Rauhamaa et al., 1990

Breast tissue from women in Helsinki





10.51 (2.00–55.26)c

aOR calculated from discordant pairs.

bAdjusted analysis.

cControlled for age and parity.


Cancers of the genitals or urinary tract include tumors of the prostate, testes, bladder, kidneys, and urinary tract. Urologic cancers account for about 41% of all cancers in men and 4% in women (ACS, 2002a).

Prostate cancer (ICD-9 185) accounts for nearly 30% of all male cancers, making it the most common cancer, excluding skin cancers, in American men (ACS, 2002a). The greatest risk factor is age; most cases occur in men over 65 years old. Other factors include family history of prostate cancer, race (prostate cancer occurs almost 70% more often in black men than in whites), and a high-fat diet (NCI, 2002q).

Although accounting for only about 1% of all cancers in men, testicular cancer (ICD-9 186.0–186.9) is the most common form of cancer in men 15–35 years old. It is one of the most curable types of cancer, with an average 5-year survival rate of more than 90%. In addition to age, risk factors are race (testicular cancer is more common in white men than in black or Asian American men), an undescended testis (cryptorchidism), abnormal testis development, Klinefelter syndrome (XXY chromosomal makeup), and family history of testicular cancer (ACS, 2000f; NCI, 2002r).

Bladder cancer (ICD-9 188.0–188.9) is the sixth most common form of cancer in the United States, excluding nonmelanoma skin cancers (ACS, 2002a). Smoking is considered the most widespread and modifiable risk factor for bladder cancer; smokers are about twice as likely as nonsmokers to develop the disease. Other risk factors include race (whites are twice as likely as blacks to be affected), sex (men are 3 times more likely to be affected than women), increasing age, and history of chronic bladder inflammation (ACS, 2001f; NCI, 2002s). Occupational exposure to carcinogens—such as benzidine and beta-naphthylamine, as seen among dye and rubber industry workers—has also been associated with significantly increased risks of bladder cancer (Miyakawa et al., 2001). Other occupations considered to pose a risk include working in the leather, textile, paint, and printing industries (ACS, 2001f).

Kidney cancer (ICD-9 189.0–189.9) shares some of the risk factors of bladder cancer, including smoking and occupational exposures, such as to asbestos, cadmium, dyes, and some organic solvents. Increased weight has been associated with kidney cancer. Genetic and hereditary factors—such as von Hippel-Lindau disease, papillary renal cell

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