Archivio Italiano di Urologia e Andrologia 2023; 95, 1 ORIGINAL PAPER major financial healthcare burden, with most recourses directed towards long-term follow-up and treatment of complications (1). Epidemiology differs among countries due to differences in lifestyle habits, environmental con- ditions, and diagnostic patterns (2), with reported inci- dence ratio in European countries ranging between 4.6 for women and 20 for men (1). One of the most identifi- able causes of bladder cancer is use of tobacco, either directly or even through environmental exposure, due to contained polycyclic aromatic hydrocarbons and aromat- ic amines (3), with nearly one out of two cases being attributed to it (4). The relationship between tobacco use and disease incidence is considered dose-related and increases the risk by three-fivefold (5). Workers occupied in industry of painting/dye, metal, petroleum and ship construction are also at increased risk due to occupation- al exposure to aromatic amines/polycyclic hydrocarbons and chlorinated hydrocarbons, accounting for nearly 10% of diagnoses (2, 3, 6, 7). Studies have shown that miners, workers in leather and rubber industry, vehicle drivers, firefighters and hairdressers are more frequently diagnosed when working more than 10 years (8, 9). Quantity or arsenic and trihalomethanes in drinking water are potentially implicated according to some reports in bladder cancer pathogenesis as well (2, 7, 10). Exposure of pelvis to ionizing radiation and administra- tion of pioglitazone or cyclophosphamide have also revealed a positive correlation with bladder cancer, while chronic mucosal lining irritation either from foreign bod- ies (long-term indwelling catheter) or infections (Schistosoma haematobium) are also considered risk factors (2, 7, 11). Obesity is considered a pandemic with reported preva- lence ranging between 30-60% across countries (12), while numerous studies have indicated increased body mass index (BMI) as an etiological factor for neoplastic disease (13). Kanabrocki et al. were the first who men- tioned a positive correlation between bladder cancer and obesity back in 1965 (14), with subsequent cohort stud- ies trying to quantify this risk showing conflicting results. Up to date the most comprehensive systematic review of literature including a total cohort of nearly 50 million participants and almost 90000 cases of bladder cancer Background: Risk factors like smoking, radi- ation, chronic infections and exposure to occupational chemicals are strongly associated with occurrence of bladder cancer. Association between increased body weight and bladder cancer has been controversial. The aim of this case- control study is to evaluate association of anthropometric char- acteristics on bladder cancer incidence in Greek population. Methods: This case-control study was conducted at a tertiary hospital in Greece with cases being patients with bladder cancer diagnosed within the last 2 years and controls patients admitted to hospital for reason other than cancer and not related to com- mon risk factors related to bladder cancer. Anthropometric characteristics like weight, height, body mass index, waist and hip circumference were measured. Analyses was done with R (Vienna, Austria). Results: Comparison between groups showed that patients with bladder cancer had higher weight, BMI and waist circumference compared to controls. However, multivariate, binomial logistic regression showed that only age (OR 1.03, 95% CI: 1-1.05, p = 0.02), no use of smoke (OR 0.12, 95% CI: 0.07-0.23, p < 0.001) and occupation related to bladder cancer (OR 7.45, 95% CI: 2.53-27.93, p < 0.001) significantly predicted the inci- dence of bladder cancer. Conclusions: Bladder cancer incidence is strongly linked with specific risk factors such as smoking, occupation with exposure to chemicals and smoke, increasing age, radiation and chronic infections. Several studies have shown a weak association between anthropometric characteristics and bladder cancer, although most studies in European populations did not confirm these findings. Similarly in our case-control study in a Greek population, we found potential relationship between increased weight/BMI and waist circumference with bladder cancer, but the association disappeared in multivariate analysis. KEY WORDS: Bladder cancer; BMI; Anthropometric characteris- tics; Epidemiology; Weight; Height; Waist circumference; Hip cir- cumference. Submitted 19 February 2023; Accepted 6 March 2023 INTRODUCTION Carcinoma of urinary bladder represents the tenth most common malignancy worldwide when both genders are considered, but the seventh for men and represents a Anthropometric characteristics and relationship with non-muscle invasive bladder cancer in Greece: A case-control study Lazaros Tzelves 1, 2 , Stamatis Katsimperis 2 , Themistoklis Bellos 2 , Marinos Berdempes 2 , Iraklis Mitsogiannis 2 , Athanasios Papatsoris 2 , Charalampos Deliveliotis 2 , Ioannis Varkarakis 2 , Andreas Skolarikos 2 1 Department of Urology/Uro-Oncology, University College of London Hospitals (UCLH), London, United Kingdom; 2 2 nd Department of Urology, Sismanoglio Hospital, Medical School, National and Kapodistrian University of Athens, Sismanogliou 37 Athens, Greece. DOI: 10.4081/aiua.2023.11266 Summary