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Treatment Related to Urinary Tract Infections Is Associated with Delayed Diagnosis of Urinary Bladder Cancer : A Nationwide Population-based Study

Liedberg, Fredrik LU ; Gårdmark, Truls ; Hagberg, Oskar LU ; Aljabery, Firas ; Ströck, Viveka ; Hosseini, Abolfazl ; Malmström, Per Uno ; Söderkvist, Karin ; Ullén, Anders and Jerlström, Tomas , et al. (2025) In European Urology Oncology 8(1). p.119-125
Abstract

BACKGROUND AND OBJECTIVE: It has been suggested that urinary tract infections (UTIs) are associated with delayed diagnosis of bladder cancer (BC). Our aim was to investigate prediagnostic treatments related to UTI and the relation to BC diagnostic delay, reflected by advanced disease at diagnosis. METHODS: We used data from the BladderBaSe 2.0 with data of treatments related to UTI up to 3 yr before BC diagnosis (2008-2019) for BC patients in comparison to a matched reference population. We investigated the association between UTI treatments and more advanced disease at diagnosis in the BC cohort. We used generalized ordered logistic regression to calculate odds ratios (ORs) for more advanced disease as an ordered outcome:... (More)

BACKGROUND AND OBJECTIVE: It has been suggested that urinary tract infections (UTIs) are associated with delayed diagnosis of bladder cancer (BC). Our aim was to investigate prediagnostic treatments related to UTI and the relation to BC diagnostic delay, reflected by advanced disease at diagnosis. METHODS: We used data from the BladderBaSe 2.0 with data of treatments related to UTI up to 3 yr before BC diagnosis (2008-2019) for BC patients in comparison to a matched reference population. We investigated the association between UTI treatments and more advanced disease at diagnosis in the BC cohort. We used generalized ordered logistic regression to calculate odds ratios (ORs) for more advanced disease as an ordered outcome: non-muscle-invasive BC (NMIBC), muscle-invasive BC (MIBC), and metastatic BC (MBC). KEY FINDINGS AND LIMITATIONS: The study population included 29 921 BC patients and 149 467 matched reference subjects. The proportions of individuals receiving UTI treatment were higher in the patient groups than in the corresponding reference groups, with the greatest differences observed for the MIBC and MBC subgroups. The OR for the risk of more advanced disease (MIBC or MBC) with at least one UTI treatment versus none was 1.28 (95% confidence interval [CI] 1.19-1.37) for men and 1.42 (95 % CI 1.27-1.58) for women. The association to risk of more advanced disease increased with the number of UTI treatments for both sexes. CONCLUSIONS AND CLINICAL IMPLICATIONS: Further studies on the effects of treatments related to UTI in combination with other factors are needed to identify reasons for possible delays in the BC diagnostic pathway. PATIENT SUMMARY: We found that for patients with bladder cancer, previous antibiotic treatment for a urinary tract infection was linked to more advanced disease at diagnosis. Further studies are needed to identify reasons for possible delays in the diagnosis of bladder cancer.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder cancer, Diagnostic delay, Register-based study, Urinary tract infection
in
European Urology Oncology
volume
8
issue
1
pages
119 - 125
publisher
Elsevier
external identifiers
  • scopus:85218503178
  • pmid:39143001
ISSN
2588-9311
DOI
10.1016/j.euo.2024.07.008
language
English
LU publication?
yes
additional info
Publisher Copyright: Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.
id
1e55c53f-6824-4354-ad3a-75b2aebe9f23
date added to LUP
2025-04-24 08:40:32
date last changed
2025-07-03 15:24:00
@article{1e55c53f-6824-4354-ad3a-75b2aebe9f23,
  abstract     = {{<p>BACKGROUND AND OBJECTIVE: It has been suggested that urinary tract infections (UTIs) are associated with delayed diagnosis of bladder cancer (BC). Our aim was to investigate prediagnostic treatments related to UTI and the relation to BC diagnostic delay, reflected by advanced disease at diagnosis. METHODS: We used data from the BladderBaSe 2.0 with data of treatments related to UTI up to 3 yr before BC diagnosis (2008-2019) for BC patients in comparison to a matched reference population. We investigated the association between UTI treatments and more advanced disease at diagnosis in the BC cohort. We used generalized ordered logistic regression to calculate odds ratios (ORs) for more advanced disease as an ordered outcome: non-muscle-invasive BC (NMIBC), muscle-invasive BC (MIBC), and metastatic BC (MBC). KEY FINDINGS AND LIMITATIONS: The study population included 29 921 BC patients and 149 467 matched reference subjects. The proportions of individuals receiving UTI treatment were higher in the patient groups than in the corresponding reference groups, with the greatest differences observed for the MIBC and MBC subgroups. The OR for the risk of more advanced disease (MIBC or MBC) with at least one UTI treatment versus none was 1.28 (95% confidence interval [CI] 1.19-1.37) for men and 1.42 (95 % CI 1.27-1.58) for women. The association to risk of more advanced disease increased with the number of UTI treatments for both sexes. CONCLUSIONS AND CLINICAL IMPLICATIONS: Further studies on the effects of treatments related to UTI in combination with other factors are needed to identify reasons for possible delays in the BC diagnostic pathway. PATIENT SUMMARY: We found that for patients with bladder cancer, previous antibiotic treatment for a urinary tract infection was linked to more advanced disease at diagnosis. Further studies are needed to identify reasons for possible delays in the diagnosis of bladder cancer.</p>}},
  author       = {{Liedberg, Fredrik and Gårdmark, Truls and Hagberg, Oskar and Aljabery, Firas and Ströck, Viveka and Hosseini, Abolfazl and Malmström, Per Uno and Söderkvist, Karin and Ullén, Anders and Jerlström, Tomas and Jahnson, Staffan and Holmberg, Lars and Häggström, Christel}},
  issn         = {{2588-9311}},
  keywords     = {{Bladder cancer; Diagnostic delay; Register-based study; Urinary tract infection}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{1}},
  pages        = {{119--125}},
  publisher    = {{Elsevier}},
  series       = {{European Urology Oncology}},
  title        = {{Treatment Related to Urinary Tract Infections Is Associated with Delayed Diagnosis of Urinary Bladder Cancer : A Nationwide Population-based Study}},
  url          = {{http://dx.doi.org/10.1016/j.euo.2024.07.008}},
  doi          = {{10.1016/j.euo.2024.07.008}},
  volume       = {{8}},
  year         = {{2025}},
}