This is a case-control association study that measured the frequencies of NAT2 genetic polymorphisms in a sample of Lebanese people with and without bladder cancer (BC) and evaluated whether smokers with slow NAT2 acetylator phenotype are at a higher risk of having BC. We have shown that BC patients were more likely to be males (87.8% vs. 54.9%) and current smokers (60.9% vs. 26.5%) as compared to controls. In both groups, most participants had the slow NAT2 acetylator phenotype (66.1% BC cases vs 62.7% controls; P=0.302) with the NAT2*5B and *6A haplotypes being the most common. The odds ratio (95%CI) of having BC among slow NAT2 acetylators was 1.157 (0.738-1.815) and remained non-significant after adjustment [1.097 (0.666-1.806)]. Sensitivity analysis with a subgroup of 113 cases and 84 controls for which occupational history is available revealed a statistically significant association between slow NAT2 acetylators and BC in females only. The sample size was however very small and the CI quite wide.

Manuscript: Nasr R, Temraz S, Mukherji D, Shamseddine A, Akika R, Abbasi S, Khauli R, Bulbul M, Tamim H, Zgheib NK. Distribution and Role of N-acetyltransferase 2 Genetic Polymorphisms in Bladder Cancer Risk in a Lebanese Population. Asian Pac J Cancer Prev. 2017 Sep 27;18(9):2561-2568 (PMID: 28952301).

The study included 115 Lebanese subjects who were diagnosed with transitional cell carcinoma (TCC) of the bladder -of which 41.1% were invasive- and who were admitted for treatment at the American University of Beirut Medical Center (AUBMC) between 2012 and 2016.  Controls included 84 patients who presented during the same recruitment period to the urology clinics or service for other complaints in addition to 222 historic controls who did not have BC but were previously recruited for a separate study (see the role of CYP2C9 and VKORC1 genetic polymorphisms on anticoagulation). 

Physician referrals of patients who approved to be consented for the study.