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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
Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; .
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2018 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 143, no 12, p. 3071-3082Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018. Vol. 143, no 12, p. 3071-3082
Keywords [en]
bladder cancer, metabolic factors, smoking, non-muscle invasive bladder cancer, muscle-invasive bladder cancer
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:umu:diva-154026DOI: 10.1002/ijc.31597ISI: 000451115900003PubMedID: 29756343OAI: oai:DiVA.org:umu-154026DiVA, id: diva2:1272993
Funder
Swedish Research Council, 2015-02322Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2018-12-20Bibliographically approved

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Häggström, ChristelJonsson, Håkan

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