Summary
Introduction:
This text provides a summary of a systematic review conducted to characterize urinary carcinogen biomarkers in electronic cigarette users and their implications for bladder cancer. The review highlights the presence and levels of excreted urinary biomarkers related to e-cigarette exposure and differences in biomarker levels among nontobacco and e-cigarette users, as well as persistent presence of worrisome biomarkers in patients who have "switched" from combustible cigarettes to e-cigarettes.
Key Points:
* The review identified 40 parent compounds and four metals in the urine of e-cigarette users, with 12 in IaRC group 1, four in group 2a, eight in group 2B, eight in group 3, and none in group 4.
* Six biomarkers have a strong link to bladder cancer, and several were detected at higher urinary levels in e-cigarette users than in controls.
* The review also found that e-cigarette use extends carcinogenic urinary biomarker levels beyond background levels of environmental exposures.
* The intensity of e-cigarette use and the association with bladder cancer risk require further investigation.
* Expert collaborative review panels have developed frameworks to guide trial and study design with respect to urinary biomarkers.
* Urologists are uniquely positioned to engage in smoking cessation efforts and drive risk reduction efforts.
* Clinicians should act on the side of caution when advising patients about the use of e-cigarettes and consider the potential for bladder cancer.
Main Message:
The text highlights the potential health risks associated with e-cigarette use, specifically in relation to bladder cancer. The review found evidence of carcinogenic urinary biomarkers in e-cigarette users, with several biomarkers having a strong link to bladder cancer. While more research is needed to establish the association with cancer and the long-term implications of chronic urothelial exposure to urinary carcinogens of e-cigarette users, the text emphasizes the importance of clinicians considering the potential for bladder cancer when advising patients about the use of e-cigarettes. Urologists are also encouraged to engage in smoking cessation efforts to drive risk reduction efforts. Overall, the text underscores the need for continued research and caution when it comes to e-cigarette use and its potential health risks.
Citation
Bjurlin Ma, Matulewicz RS, Roberts TR, et al. Carcinogen Biomarkers in the Urine of Electronic Cigarette Users and Implications for the Development of Bladder Cancer: a Systematic Review. European urology oncology. 2021;4(5):766-783. doi:10.1016/j.euo.2020.02.004
