Despite their known pulmonary, neurological, and carcinogenic risks, electronic cigarette (e-cigarette) use has increased drastically in recent years, especially among adolescents and young adults. In a recent study, a team of researchers led by Marc Bjurlin, DO, MSc, Associate Professor of Urology at the University of North Carolina Chapel Hill's Lineberger Comprehensive Cancer Center, analyzed the urine samples of e-cigarette users and identified the presence of several carcinogenic biomarkers that are strongly linked to bladder cancer. In this interview with i3 Health, Dr. Bjurlin discusses the significance of the study's findings and the increased risk of bladder cancer faced by individuals who use e-cigarettes.
What prompted you to investigate the link between e-cigarette use and bladder cancer risk?
Marc Bjurlin, DO, MSc: Most prior research regarding the health implications of vaping has focused on pulmonary complications. However, several recent studies have also identified toxicants and carcinogens in the urine of e-cigarette users, highlighting the metabolized byproducts of vaping.
What is the significance of your findings regarding the association between e-cigarette use and bladder cancer risk?
Dr. Bjurlin: Our study reviewed the scientific literature and found several carcinogens in the urine of e-cigarette users that are linked to the development of bladder cancer. We also identified many of the toxicants and carcinogens found in the urine of e-cigarette users as similar to those carcinogens observed in the urine of smokers of combustible cigarettes. This is important because combustible cigarette smoking is the most common risk factor for the development of bladder cancer.
Did the study have any limitations?
Dr. Bjurlin: The population was heterogenous. Several of the studies that we evaluated included dual users, individuals who used both e-cigarettes and combustible cigarettes. As a result, it was difficult to determine the source of certain carcinogens.
What further research needs to be done regarding the link between e-cigarettes and bladder cancer?
Dr. Bjurlin: As next steps, we have secured grant funding to investigate several different bladder cancer-related carcinogens in the urine of e-cigarette–only users, never users, and combustible tobacco users to help address the limitations of our current study.
About Dr. Bjurlin
Marc Bjurlin, DO, MSc, is an Associate Professor of Urology at the University of North Carolina Chapel Hill's Lineberger Comprehensive Cancer Center. He specializes in the treatment of genitourinary malignancies, including bladder, prostate, testicular, and kidney cancer. Dr. Bjurlin has served on several national committees to establish clinical practice guidelines for the management of genitourinary cancers, including the American Urological Association's committee to establish standard operating procedure for the use of magnetic resonance imaging (MRI) in prostate cancer. He has authored or coauthored numerous publications in peer-reviewed journals, and his research focuses on the development and use of advanced surgical procedures, including robotic surgery, to improve outcomes in patients with genitourinary malignancies.
For More Information
Bjurlin MA, Matulewicz RS, Roberts TS, et al (2020). Carcinogen biomarkers in the urine of electronic cigarette users and implications for the development of bladder cancer: a systematic review. Eur Urol Oncol. [Epub ahead of print] DOI:10.1016/j.euo.2020.02.004
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of i3 Health.