For many years, mortality rates for bladder cancer have been higher in New England than in the rest of the country. While incidence rates are much higher in whites than in African Americans, mortality rates are only slightly higher, due in large part to the later stage at diagnosis among African Americans. Incidence and mortality rates for Hispanics and Asians/Pacific Islanders are lower than those for whites and African Americans. Overall incidence and mortality have changed very little for most racial and ethnic groups over the past 20 years. Men have greater incidence and mortality rates than women.
This population-based, case-control study of bladder cancer in New Hampshire, Vermont, and Maine sought to explain the reason for the persistent excess of bladder cancer mortality and incidence in the northern New England area.
Data analyses are underway to explore the use of well water from private sources, which may contain elevated levels of arsenic, in relation to the excess bladder cancer rates in New England. Also, smoking fewer cigarettes over a long time appears to be more harmful than smoking more cigarettes over a shorter time.