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

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 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.

The relationship between metabolic syndrome and its components with bladder cancer: a systematic review and meta-analysis of cohort studies

“…Finally, the quality of 55 related studies that satisfied the inclusion criteria was assessed. Of these, 11 studies were performed in the United States [23,[26][27][28][29][30][31][32][33][34][35], 8 studies in Sweden [19,21,[36][37][38][39][40][41], 8 studies in Korea [42][43][44][45][46][47][48][49], 6 studies in the United Kingdom [20,[50][51][52][53][54], 7 studies in Taiwan [55][56][57][58][59][60][61], 2 studies each in China [62,63], Japan [64,65], Italy [66,67], Scotland [68,69], and Austria [70,…”

Can Routine Blood and Urine Parameters Reveal Clues to Detect Bladder Cancer? A Case–Control Study

“…Statistical significance was observed for the comparison of the BMI between cases and controls (p < 0.001). By contrast, three Swedish cohorts, which included 340,000 men, indicated that BMI (hazard ratio (HR) = 1.02, 95% CI = 0.98-1.08) and systolic blood pressure (HR = 0.98, 95% CI = 0.94-1.02) showed no statistically significant associations with bladder cancer outcomes (13). A prospective pooled cohort study stated that the effects of BMI on bladder cancer varied between males and females.…”

Association of Hypertension and Organ-Specific Cancer: A Meta-Analysis

“…After conducting a hand search specifically for studies from 2017 to 2021, 22 studies were identified. In total 47 studies were identified without the use of machine learning [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ]. Of these 47 studies, 22 were published after 2017, as one of our focuses was to obtain more recent publications as new data have been introduced over the past 5 years since the previous meta-analysis was conducted [ 5 ].…”

“…In the subgroup analysis of SBP and DBP per 10 mmHg, SBP showed a positive dose-dependent association with RCC ( Figure 3 ; n = 2; RR: 2.26; CI: 1.50–3.62; I 2 : 92.9%) [ 25 , 65 ] and muscle-invasive bladder cancer (MIBC) ( Figure 3 ; n = 2; RR: 1.29; CI: 1.05–1.57; I 2 : 0%) [ 31 , 32 ]. DBP also showed a positive dose-dependent association with RCC ( Figure 4 ; n = 2; RR: 2.28; CI: 1.50–3.65; I 2 : 90.8%) [ 25 , 65 ].…”

“…In a study involving bladder cancer, high blood pressure was associated with increased risk and mortality among men, and blood pressure showed a graded increase in strength of association from overall bladder cancer, NMIBC, MNIBC, and bladder cancer mortality [ 31 ]. Dose-dependent SBP has been associated with bladder cancer mortality in an analysis of never-smokers, which is important to note, as smoking is one of the largest risk factors for bladder cancer (accounting for approximately 50% of cases) [ 32 ]. Other studies have also concluded that hypertension induces a poor overall survival rate and an increased risk of cancer mortality [ 6 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], for cancers of the oropharynx, rectum, pancreas, lung, prostate, bladder, and kidney for men and pancreas, breast (women with the highest combined blood pressure tertial were at a 41% increased risk of total mortality compared with women in the lowest tertial [ 39 ]), endometrial, and malignant melanoma for women and esophagus cancers for both [ 6 ].…”