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How Metabolic Factors May Influence Bladder Cancer Risk and Mortality

By: Jenna Carter, PhD
Posted: Friday, April 9, 2021

In a recent article published in Cancer Medicine, researchers examined the relation between blood pressure and obesity on bladder cancer risk and mortality. Although well researched, the connection between bladder cancer and metabolic factors is not well characterized due to confounding variables, including smoking. Tanja Stocks, PhD, of Lund University, Sweden, and colleagues analyzed data on nearly 340,000 men from 3 Swedish cohorts. Their analyses of risk by disease stage and grade revealed modest associations between body mass index and non–muscle-invasive bladder cancer as well as grade 3 non–muscle-invasive bladder cancer. Additionally, they found associations among systolic blood pressure, muscle-invasive bladder cancer, and bladder cancer–specific mortality in both smokers and never-smokers.

A total of 338,910 men were included in this study. Cox proportional hazards regression was used to calculate hazard ratios for the risk of bladder cancer endpoints based on metabolic factors. Participants were followed from the date of baseline examination until diagnosis of another cancer, emigration, death, or until the end of follow‐up. Cox regressions were also used to calculate hazard ratios adjusted for smoking status.

Overall, their findings revealed that body mass index was positively associated with non–muscle-invasive bladder cancer (hazard ratio per 5 kg/m2 = 1.10 [1.02–1.19]) and grade 3 non–muscle-invasive bladder cancer (hazard ratio = 1.17 [1.01–1.34]) in the full cohort. Systolic blood pressure was positively associated with muscle‐invasive bladder cancer (hazard ratio per 10 mm Hg = 1.25 [1.00–1.55]) and bladder cancer–specific mortality (HR = 1.10 [1.01–1.20]) among never‐smokers. However, there were weaker and nonsignificant associations in the full cohort.

“The findings on grade and among never‐smokers underscore the importance of additionally investigating grade in the assessment of tumor aggressiveness, and the importance of minimizing the influence of smoking…,” concluded Dr. Stocks and colleagues.

Disclosure: The authors reported no conflicts of interest.



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