2nd August 2023

A 66-year-old man presents with a 2-month history of urinary frequency, haematuria and weight loss.

A 66-year-old man presents with a 2-month history of urinary frequency, haematuria and weight loss. He is native to Cameroon and lived there until he moved to England at the age of 45. Cystoscopy reveals a tumour of the bladder.

Which is the most likely cause of his bladder cancer?

Select the SINGLE most appropriate option from the list below. Select ONE option only.