Urothelial cancer has been linked with tobacco, phenacetin-containing analgesics and some industrially-related carcinogens. Carotene has been suggested as reducing the risk of urothelial cancer but there is not much information on the relation between diet and the incidence of human urothelial cancer. Furthermore, the magnitude of the risk of urothelial cancer for pipe smokers remains unclear. In a 14-year follow-up of 16,477 Swedish twins the rate ratio of urothelial cancer (with 95% confidence interval) for subjects with a moderate/high intake of pork and beef respectively was 1.6 (1.0-2.7) and 1.6 (1.0-2.6). Meat consumption is widespread in Western populations. If the finding is supported by further data, a possible etiologic factor associated with the consumption of beef and pork would account for a substantial proportion of the cases of urothelial cancer. The rate ratio for men smoking a pipe/cigars, but not cigarettes, was 3.3 (95% confidence interval 1.5-7.4).