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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

Teleka, Stanley LU ; Häggström, Christel ; Nagel, Gabriele ; Bjørge, Tone LU ; Manjer, Jonas LU ; Ulmer, Hanno ; Liedberg, Fredrik LU ; Ghaderi, Sara ; Lang, Alois and Jonsson, Håkan , et al. (2018) In International Journal of Cancer 143(12). p.3071-3082
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... (More)

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 (pinteraction ≤ 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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder cancer, metabolic factors, muscle-invasive bladder cancer, non-muscle invasive bladder cancer, smoking
in
International Journal of Cancer
volume
143
issue
12
pages
3071 - 3082
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85055171050
  • pmid:29756343
ISSN
0020-7136
DOI
10.1002/ijc.31597
project
Metabolic factors, smoking and genetic variation in relation to bladder cancer risk and prognosis
language
English
LU publication?
yes
id
5753a530-95c2-41c6-b511-03820d24aa11
date added to LUP
2018-12-17 15:15:26
date last changed
2024-04-15 18:49:23
@article{5753a530-95c2-41c6-b511-03820d24aa11,
  abstract     = {{<p>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<sub>interaction</sub> ≤ 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.</p>}},
  author       = {{Teleka, Stanley and Häggström, Christel and Nagel, Gabriele and Bjørge, Tone and Manjer, Jonas and Ulmer, Hanno and Liedberg, Fredrik and Ghaderi, Sara and Lang, Alois and Jonsson, Håkan and Jahnson, Staffan and Orho-Melander, Marju and Tretli, Steinar and Stattin, Pär and Stocks, Tanja}},
  issn         = {{0020-7136}},
  keywords     = {{bladder cancer; metabolic factors; muscle-invasive bladder cancer; non-muscle invasive bladder cancer; smoking}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{3071--3082}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.1002/ijc.31597}},
  doi          = {{10.1002/ijc.31597}},
  volume       = {{143}},
  year         = {{2018}},
}