ATM and urinary bladder cancer: ATM mutations have been identified in patients with bladder cancer and are associated with inferior overall survival.19 A retrospective analysis of patients with relapsed or advanced urothelial carcinoma who had undergone genomic sequencing or were selected from The Cancer Genome Atlas bladder cohort found nearly 15% with ATM alterations, and that these alterations correlated with shorter survival.20 A possible explanation for their presence is the strong association between cigarette smoking and the increased risk of bladder cancer.