The role of parabens in bladder cancer

Bladder cancer is a common disease with high morbidity and mortality worldwide. Parabens and aromatic alcohols are commonly used preservatives in personal care products. Studies in the literature have linked parabens to infertility, obesity, breast cancer, and prostate cancer; however, there is no information available regarding bladder cancer. In our study, we aimed to measure the levels of 7 parabens and 2 aromatic alcohol compounds in bladder tissue and investigate their relationship with bladder cancer. Following ethical approval, male patients who underwent transurethral resection of bladder tumor (TUR-BT) for bladder cancer diagnosis and transurethral resection of prostate (TUR-P) for clinical benign prostatic obstruction (BPO) between 16.11.2022 - 09.08.2023 at Pamukkale University Faculty of Medicine Urology Clinic were included in the study. Participants' age, height, weight, number of children (NC), occupation, presence of chronic diseases, smoking, and personal care product use were recorded. According to the calculated power analysis, it was decided to include a minimum of 26 participants in each patient and control group. Bladder tumor tissue in the patient group and healthy bladder tissue in the control group were obtained. After the trial, all samples were analyzed by chromatographic method using high performance liquid chromatography (HPLC) device following pre-processing. Demographic data and analysis results were subjected to statistical processing. There were 26 male patients in both patient and control groups. The mean ages in the patient and control groups were calculated as 71.5 and 70.5, respectively. 17 patients were diagnosed with non-muscle invasive bladder cancer (NMIBC) and 9 patients were diagnosed with muscle-invasive bladder cancer (MIBC). 4 patients diagnosed with NMIBC were clinically considered as MIBC. Thus, there were 13 patients in both invasive and non-invasive groups. Except for smoking, no difference was observed between patient and control groups in terms of age, body mass index, comorbid disease, occupation, and number of children. No difference was observed in the use of soap, shampoo, toothpaste, and deodorant containing parabens and aromatic alcohols between groups. Among parabens, propylparaben (PrP) was detected at the highest rate with a rate of 21.2%. Butylparaben and isobutylparaben were detected below the limit of detection (LOD). No statistically significant difference was found categorically and numerically among measurable parabens; however, it was observed to be high in the patient group. PE and PP were statistically significant and detected at high levels in the patient group compared to the control group. PP and smoking have been identified as factors increasing the risk of bladder cancer in logistic regression analysis; however, the relationship between PE levels and bladder cancer risk could not be evaluated as they did not fit the test. No correlation was found between PE, PP, and variables. Studies have shown that parabens cause DNA damage, glycolipid metabolism disorders, and can cause cancer by exhibiting estrogen-like effects. In this study, the relationship between parabens and bladder cancer could not be established. Additionally, the association of PP with bladder cancer has been observed. There is a need for further studies with increased sample size using urine samples from bladder cancer cases and tumor and tumor-free bladder tissues.