Correlation Between NAT2 Slow Acetylation and Bladder Cancer Drawn

A data metaanalysis supports the potential correlation between NAT2 slow acetylation and the risk of bladder cancer.

​The study authors searched PubMed, Cochran, McGrane English databases, CBM, CNKI, and other databases and explored 20 studies analyzing the correlation between NAT2 and bladder cancer.

Criteria included English, randomized, prospective or retrospective control studies or cohort studies with complete and credible data. Non-English literature was not included and data without summaries were excluded.

A total of 50 records were identified via data search; 34 in total after duplicate studies were removed. A total of 12 articles were cited by phenotypic NAT2 gene description and eight cited genotype. Genetic data were cited. Age of patients in the control group were matched with the case group. Smoking history and occupational exposure was analyzed.

"Currently the view [of] exposure to carcinogens as a risk factor for bladder cancer, has been a broad consensus. That is the reason why NAT2 slow acetylator has been recognized as a factor for assessing bladder cancer risk. At present, some studies failed to prove the relationship between NAT2 slow acetylator status and bladder cancer, and the main reason can be attributed to the differences in statistical sample size," said the authors in the study.

"Only a few studies in the bilateral 5% statistical level have significant sexual differences. In our study, we also cannot discover the significant sexual differences (data not shown). The advantage of this study is that the statistical data can be combined and analyzed by different methods.

According to the study authors, bladder cancer is directly related to environmental carcinogens. High-risk individuals include those who work in factories that produce rubber, as well as people who work in the dye and printing industries, because of chemical exposure. Workers who inhale diesel exhaust and smoke are also at risk.

“These factories bring aromatic amine that mainly include high polymer aromatic amines, such as naphthylamine, 4-aminobiphenyl, benzidine, and their N-hydroxylated derivative. All of these are known or potential NAT2 substrates,” state the study authors. “[The current view is that] exposure to carcinogens is a risk factor for bladder cancer. That is the reason why NAT2 slow acetylator has been recognized as a risk factor for assessing bladder cancer risk.”


  1. Zhu Z, Zhang J, Jiang W. Risks on N-acetyltransferase 2 and bladder cancer: a meta-analysis. OncoTargets and Ther. 2015 (8): 3715-3720. Accessed December 21, 2015.