Risk of bladder cancer by disease severity in relation to metabolic factors and smoking: A prospective pooled cohort study of 800, 000 men and women. Issue 12 (16th October 2018)

• Record Type: Journal Article
• Authors: Teleka, Stanley; Häggström, Christel; Nagel, Gabriele; Bjørge, Tone; Manjer, Jonas; Ulmer, Hanno; Liedberg, Fredrik; Ghaderi, Sara; Lang, Alois; Jonsson, Håkan; Jahnson, Staffan; Orho‐Melander, Marju; Tretli, Steinar; Stattin, Pär; Stocks, Tanja
• Is Part Of: International journal of cancer. Volume 143:Issue 12(2018)
• Page Start: 3071
• Page End: 3082
• Publication Date: 2018-10-16
• Subjects: bladder cancer -- metabolic factors -- smoking -- non‐muscle invasive bladder cancer -- muscle‐invasive bladder cancer; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.31597
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : Previous studies on metabolic factors and bladder cancer (BC) risk have shown inconsistent results and have commonly not investigated associations separately by sex, smoking, and tumor invasiveness. Among 811, 633 participants in six European cohorts, we investigated sex‐specific associations between body mass index (BMI), mid‐blood pressure (BP, [systolic + diastolic]/2), plasma glucose, triglycerides, total cholesterol and risk of BC overall, non‐muscle invasive BC (NMIBC) and muscle invasive BC (MIBC). Among men, we additionally assessed additive interactions between metabolic factors and smoking on BC risk. During follow‐up, 2, 983 men and 754 women were diagnosed with BC. Among men, triglycerides and BP were positively associated with BC risk overall (hazard ratio [HR] per standard deviation [SD]: 1.17 [95% confidence interval (CI) 1.06–1.27] and 1.09 [1.02–1.17], respectively), and among women, BMI was inversely associated with risk (HR: 0.90 [0.82–0.99]). The associations for BMI and BP differed between men and women ( p interaction ≤ 0.005). Among men, BMI, cholesterol and triglycerides were positively associated with risk for NMIBC (HRs: 1.09 [95% CI 1.01–1.18], 1.14 [1.02–1.25], and 1.30 [1.12–1.48] respectively), and BP was positively associated with MIBC (HR: 1.23 [1.02–1.49]). Among women, glucose was positively associated with MIBC (HR: 1.99 [1.04–3.81]). Apart from cholesterol, HRs for metabolic factors did not significantly differ between MIBC and NMIBC, and there were no interactions between smoking and metabolic factors on BC. Our study supports an involvement of metabolic aberrations in BC risk. Whilst some associations were significant only in certain sub‐groups, there were generally no significant differences in associations by smoking or tumor invasiveness. Abstract : What's new? While associations between obesity and bladder cancer (BC) are suspected, studies to date are inconclusive. Relationships between other metabolic factors and BC are also uncertain. In this study, overall BC risk and risk of non‐muscle invasive BC and muscle invasive BC (MIBC) were found to differ according to sex and metabolic factor. Elevated triglycerides and blood pressure were associated with increased BC mortality risk in men. In women, glucose was a significant factor for MIBC and body mass index was inversely associated with BC risk. No interactions were detected between metabolic factors and smoking in relation to bladder cancer.