Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts

Teleka, Stanley LU ; Jochems, Sylvia H.J. LU ; Häggström, Christel LU ; Wood, Angela M. ; Järvholm, Bengt ; Orho-Melander, Marju LU ; Liedberg, Fredrik LU and Stocks, Tanja LU (2021) In Cancer Medicine 10(4). p.1431-1438
Abstract

Background: The relation between obesity, blood pressure (BP) and bladder cancer (BC) risk and mortality remains unclear, partially due to potential confounding by smoking, the strongest risk factor for BC, and not accounting for tumor stage and grade in such studies. We investigated body mass index (BMI) and BP in relation to BC risk by stage and grade, and BC-specific mortality, including separately among never-smokers aimed at minimizing confounding by smoking. Methods: We analyzed 338,910 men from three Swedish cohorts, with 4895 incident BC's (940 among never-smokers) during follow-up. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals adjusted for smoking status. HRs for BMI and BP were corrected... (More)

Background: The relation between obesity, blood pressure (BP) and bladder cancer (BC) risk and mortality remains unclear, partially due to potential confounding by smoking, the strongest risk factor for BC, and not accounting for tumor stage and grade in such studies. We investigated body mass index (BMI) and BP in relation to BC risk by stage and grade, and BC-specific mortality, including separately among never-smokers aimed at minimizing confounding by smoking. Methods: We analyzed 338,910 men from three Swedish cohorts, with 4895 incident BC's (940 among never-smokers) during follow-up. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals adjusted for smoking status. HRs for BMI and BP were corrected for their regression dilution ratios, calculated from 280,456 individuals with 758,641 observations. Results: Body mass index was positively associated with non-muscle invasive BC (NMIBC, HR per 5 kg/m2, 1.10 [1.02–1.19]) and NMIBC grade 3 (HR 1.17 [1.01–1.34]) in the full cohort, with similar effect sizes, albeit non-significant, among never-smokers. Systolic BP was positively associated with muscle-invasive BC (MIBC, HR per 10 mmHg, 1.25 [1.00–1.55]) and BC-specific mortality (HR 1.10 [1.01–1.20]) among never-smokers, with weaker and non-significant associations in the full cohort. Conclusions: In an analyses of BMI, BP and BC risk by stage and grade among men, we found modest positive associations between BMI and NMIBC and NMIBC grade 3. SBP was positively associated with MIBC and BC-specific mortality in an analysis of never-smokers, which may reflect the association, un-confounded by smoking, also in a broader population.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder cancer, blood pressure, body mass index, confounding, survival analysis
in
Cancer Medicine
volume
10
issue
4
pages
1431 - 1438
publisher
Wiley-Blackwell
external identifiers
  • scopus:85099360201
  • pmid:33455057
ISSN
2045-7634
DOI
10.1002/cam4.3721
project
Metabolic factors, smoking and genetic variation in relation to bladder cancer risk and prognosis
language
English
LU publication?
yes
id
35ff7758-ccff-4059-90e1-ae83b4a42adb
date added to LUP
2021-01-25 10:38:02
date last changed
2024-06-13 06:09:13
@article{35ff7758-ccff-4059-90e1-ae83b4a42adb,
  abstract     = {{<p>Background: The relation between obesity, blood pressure (BP) and bladder cancer (BC) risk and mortality remains unclear, partially due to potential confounding by smoking, the strongest risk factor for BC, and not accounting for tumor stage and grade in such studies. We investigated body mass index (BMI) and BP in relation to BC risk by stage and grade, and BC-specific mortality, including separately among never-smokers aimed at minimizing confounding by smoking. Methods: We analyzed 338,910 men from three Swedish cohorts, with 4895 incident BC's (940 among never-smokers) during follow-up. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals adjusted for smoking status. HRs for BMI and BP were corrected for their regression dilution ratios, calculated from 280,456 individuals with 758,641 observations. Results: Body mass index was positively associated with non-muscle invasive BC (NMIBC, HR per 5 kg/m<sup>2</sup>, 1.10 [1.02–1.19]) and NMIBC grade 3 (HR 1.17 [1.01–1.34]) in the full cohort, with similar effect sizes, albeit non-significant, among never-smokers. Systolic BP was positively associated with muscle-invasive BC (MIBC, HR per 10 mmHg, 1.25 [1.00–1.55]) and BC-specific mortality (HR 1.10 [1.01–1.20]) among never-smokers, with weaker and non-significant associations in the full cohort. Conclusions: In an analyses of BMI, BP and BC risk by stage and grade among men, we found modest positive associations between BMI and NMIBC and NMIBC grade 3. SBP was positively associated with MIBC and BC-specific mortality in an analysis of never-smokers, which may reflect the association, un-confounded by smoking, also in a broader population.</p>}},
  author       = {{Teleka, Stanley and Jochems, Sylvia H.J. and Häggström, Christel and Wood, Angela M. and Järvholm, Bengt and Orho-Melander, Marju and Liedberg, Fredrik and Stocks, Tanja}},
  issn         = {{2045-7634}},
  keywords     = {{bladder cancer; blood pressure; body mass index; confounding; survival analysis}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{4}},
  pages        = {{1431--1438}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Cancer Medicine}},
  title        = {{Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts}},
  url          = {{http://dx.doi.org/10.1002/cam4.3721}},
  doi          = {{10.1002/cam4.3721}},
  volume       = {{10}},
  year         = {{2021}},
}