Smoking is associated with lower age, higher grade, higher stage, and larger size of malignant bladder tumors at diagnosis. Issue 2 (13th February 2013)

• Record Type: Journal Article
• Authors: van Roekel, Eline H.; Cheng, Kar K.; James, Nicholas D.; Wallace, D. Michael A.; Billingham, Lucinda J.; Murray, Paul G.; Bryan, Richard T.; Zeegers, Maurice P.
• Is Part Of: International journal of cancer. Volume 133:Issue 2(2013:Jul. 15)
• Page Start: 446
• Page End: 454
• Publication Date: 2013-02-13
• Subjects: smoking -- bladder cancer -- epidemiology; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.28017
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Smoking is a strong risk factor of bladder cancer (BC), but it is currently unclear whether smoking is also associated with severity of BC at diagnosis. We performed a large hospital‐based case‐comparison study, examining the relation between smoking and clinical characteristics of BC at diagnosis. A total of 1, 544 cases from participating hospitals in the West Midlands were recruited between 19 December 2005 and 21 April 2011. Eligible cases were adult BC patients without a previous history of this disease. At time of diagnosis, semi‐structured face‐to‐face interviews were conducted by trained research nurses to collect smoking information. Clinical characteristics were obtained from medical records. Linear mixed models were performed to calculate predicted means in clinical outcomes for a variety of smoking behaviors. A p < 0.05 was considered statistically significant. After adjustment for age and gender, current smokers were on average 4.0 years younger at diagnosis (95% CI: −5.9 to −2.0), had larger tumors (mean difference: 0.48 cm, 95% CI: 0.04−0.91), a higher T stage (mean difference: 0.25, 95% CI: 0.08−0.41), and a borderline significantly higher grade than never smokers (mean difference: 0.15, 95% CI: 0.00−0.30). Our results suggest that smoking could be associated with a more malignant phenotype of BC at diagnosis. More research is needed on the relation between smoking and prognosis, but our results could strengthen the message about the potential risks of smoking to these patients. Abstract : What's new? Smoking is associated with an increased risk of bladder cancer, but the relationship between lifetime smoking characteristics and clinical presentation of the disease at diagnosis remains limited. In this study, one of the first to investigate this relationship, current smokers were found to be younger and to have larger tumors, higher T stage, and marginally higher tumor grade at diagnosis compared with never smokers. The findings suggest that smoking could be associated with a more malignant type of bladder cancer at diagnosis and could help strengthen the message about the potential risks of smoking.