Risk of Malignant Neoplasms of Kidney and Bladder in a Cohort Study of the Diabetic Population in Taiwan With Age, Sex, and Geographic Area Stratifications. Issue 38 (September 2015)

• Record Type: Journal Article
• Authors: Chen, Hua-Fen; Chen, Shwe-Winn; Chang, Ya-Hui; Li, Chung-Yi; Gao., Chun
• Is Part Of: Medicine. Volume 94:Issue 38(2015)
• Publication Date: 2015-09
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000001494
• Languages: English
• ISSNs: 0025-7974

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>Diabetes has been reported to increase the risk of malignant neoplasms of kidney and bladder, but the studies' results are still inconclusive. Age, sex, and geographical area-specific incidence and relative risks of above neoplasms are also scarce in the literature. We prospectively investigated the age, sex, geographical area-specific incidence and relative risks of kidney and bladder neoplasms in diabetic population of Taiwan.</p> <p>Diabetic patients (n = 615, 532) and age- and sex-matched controls (n = 614, 871) were linked to inpatient claims (2000–2008) to identify the admissions for malignant neoplasm of kidney (International Classification of Diagnosis, 9th version, Clinical Modification: 189) and bladder (International Classification of Diagnosis, 9th version, Clinical Modification: 188). The person-year approach with Poisson assumption was used to evaluate the incidence density. We also estimated the age, sex, and geographical area-specific relative risks of above malignancy in relation to diabetes with Cox proportional hazard regression model.</p> <p>The overall incidence density of malignant neoplasm of kidney for diabetic men and women were 3.87 and 4.28 per 10, 000 patient-years, respectively; the corresponding figures for malignant neoplasm of bladder were 5.73 and 3.25 per 10, 000 patient-years. Compared with the controls, diabetic men were at significantly increased hazards of kidney (covariate adjusted hazard ratio [aHR]: 1.31, 95% confidence interval [CI] 1.18–1.46) and bladder aHR: 1.13, 95% CI 1.04–1.23). Diabetic women, on the contrary, only experienced significantly elevated hazard of kidney neoplasm (aHR: 1.14, 95% CI 1.04–1.26). Diabetic men aged >65 years showed the most significantly increased hazard of developing neoplasm of kidney (aHR: 1.40) and bladder (aHR: 1.13). The most significantly increased hazard of kidney neoplasm was noted for women diabetic patients aged >65 years. There was also a significant interactive effect of geographic area with diabetes on the incidence of kidney and bladder neoplasms in both sexes.</p> <p>Diabetic men >45 years and diabetic women >65 years were found to have significantly increased hazard of malignant neoplasm of kidney, but only diabetic men >65 years were at significantly increased hazard of bladder neoplasm. The significant geographic variations in incidence and relative hazard of kidney and bladder neoplasms warrant further investigations of the underlying reasons.</p> </sec> </abstract>