People who use e-cigarettes have six substances that have a strong link to bladder cancer in their urine, researchers reported in European Urology Oncology.

The researchers compiled the results from 22 studies that analyzed the urine of people who used e-cigarettes or other tobacco products, including cigarettes. They found the presence of 40 compounds that the body may process to produce 63 toxic chemicals or carcinogenic metabolites. Six of those chemicals have a strong link to bladder cancer, according to international carcinogen databases.

Some of the studies in the analysis reported that e-cigarette users had significantly higher levels of the carcinogens in their urine compared to people who had never used them.

“This finding shows us that people who vape will be exposed to a variety of different carcinogens,” the authors said. “People who have decades of exposure to these carcinogens from vaping may be at risk for developing malignancies, especially bladder cancer.”

Learn more about ONS’s position on e-cigarettes and vaping. Listen to a discussion about the youth vaping epidemic on the Oncology Nursing Podcast.