Volume 130, Issue 4 pp. 896-901
Epidemiology

Cigarette smoking and subtypes of bladder cancer

Xuejuan Jiang

Corresponding Author

Xuejuan Jiang

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

X.J. and J.E.C. contributed equally to this work

Tel: [+1-323-865-0433], Fax: +[1-323-865-0140]

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California; 1441 Eastlake Avenue, Los Angeles, California 90089, USASearch for more papers by this author
J. Esteban Castelao

J. Esteban Castelao

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

Complejo Hospitalario Universitario de Vigo, Vigo, Spain

X.J. and J.E.C. contributed equally to this work

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Jian-Min Yuan

Jian-Min Yuan

Division of Epidemiology and Community Health, The Masonic Cancer Center, School of Public Health, University of Minnesota, Minneapolis, MN

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Mariana C. Stern

Mariana C. Stern

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

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David V. Conti

David V. Conti

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

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Victoria K. Cortessis

Victoria K. Cortessis

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

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Malcolm C. Pike

Malcolm C. Pike

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY

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Manuela Gago-Dominguez

Manuela Gago-Dominguez

Department of Preventive Medicine, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA

Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain

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First published: 15 March 2011
Citations: 53

Tel: [+1-323-865-0433], Fax: +[1-323-865-0140]

Abstract

There is little information regarding associations between suspected bladder cancer risk factors and tumor subtypes at diagnosis. Some, but not all, studies have found that bladder cancer among smokers is often more invasive than it is among nonsmokers. This population-based case-control study was conducted in Los Angeles, California, involving 1,586 bladder cancer patients and their individually matched controls. Logistic regression was used to conduct separate analyses according to tumor subtypes defined by stage and grade. Cigarette smoking increased risk of both superficial and invasive bladder cancer, but the more advanced the stage, the stronger the effect. The odds ratios associated with regular smokers were 2.2 (95% confidence intervals, 1.8–2.8), 2.7 (2.1–3.6) and 3.7 (2.5–5.5) for low-grade superficial, high-grade superficial and invasive tumors respectively. This pattern was consistently observed regardless of the smoking exposure index under examination. Women had higher risk of invasive bladder cancer than men even they smoked comparable amount of cigarettes as men. There was no gender difference in the association between smoking and risk of low-grade superficial bladder cancer. The heterogeneous effect of cigarette smoking was attenuated among heavy users of NSAIDs. Our results indicate that cigarette smoking was more strongly associated with increased risk of invasive bladder cancer than with low-grade superficial bladder cancer.

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