Bladder cancer and reproductive factors among women in Spain

Abstract

Hormonal factors, possibly related to reproductive characteristics, may play a role in the risk of bladder cancer among women. To study this, we investigated the effects of reproductive factors on female bladder cancer risk. Information on reproductive and other risk factors was gathered in personal interviews from 152 female cases and 166 matched controls from 18 hospitals in five regions of Spain during 1998-2001. Logistic regression was used to estimate the association between bladder cancer and reproductive factors, including ever-parous status, age at first live birth, age at last live birth, age at menarche, age at menopause, menopausal status, and duration of menstruation. After adjustment for age, smoking, and high-risk occupation, ever-parous women were at decreased risk relative to nulliparous women (odds ratio = 0.43, 95% confidence interval = Correspondence to: An-Tsun Huang, huangan@mail.nih.gov. NIH Public Access Author ManuscriptCancer Causes Control. Author manuscript; available in PMC 2011 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript 0.21-0.87). There was no consistent pattern in risk with the age-or duration-related reproductive factors (e.g., age at first live birth, age at last live birth, age at menarche, age at menopause, menopausal status, and duration of menstruation) that we evaluated. Women have a lower risk of bladder cancer than men, and hormonal factors related to childbearing may play a role.

Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?

“…Among patients with persistent haematuria, mean parity also did not differ between patients with and without bladder cancer (p=0.38). In contrast to our findings, there are numerous studies suggesting that the risk of bladder cancer is higher in nulliparous women and the risk of bladder cancer decreases with increasing parity (Prizment et al, 2007;Huang et al, 2009). A recent study demonstrated 30% reduction in the risk of bladder cancer in multiparous compared to nulliparous women (Dietrich et al, 2011).…”

“…Although Prizment et al (2007) reported increasing risk of bladder cancer with decreasing ovulatory years in women's life, we did not observe an increased incidence of bladder cancer in postmenopausal period (p=0.30). Our study is limited by the sample size; however, similar to our study, Huang et al (2009) studied the association between bladder cancer and reproductive factors in Spanish women and did not report an increased risk of bladder cancer in association with menopausal status. During menopause, many factors such as obesity, eating habits and androgen levels in peripheral circulation affect the levels of oestrogen derivatives in the circulation (Aubertin-Leheudre et al, 2011).…”

“…This might have been caused by the changes in the life styles of men and women in time, which, until today, is thought to have provided protection against bladder cancer in women. Besides, there is still no clear consensus on the protective effects of hormonal and reproductive factors in women (McGrath et al, 2006;Huang et al, 2009). In order to clearly indicate the effects of reproductive factors, we evaluated only non-smoker women who had not previously worked in high risk occupations for bladder cancer.…”

“…Sex steroids cause symptomatic and functional alterations in the bladder (McGrath et al, 2006;Huang et al, 2009). The prevalence of detrusor instability, urinary incontinence and recurrent urinary tract infections that cause chronic inflammation may vary depending on the specific reproductive phase of female patient (Hextall, 2000;Aikawa et al, 2003).…”

“…The prevalence of detrusor instability, urinary incontinence and recurrent urinary tract infections that cause chronic inflammation may vary depending on the specific reproductive phase of female patient (Hextall, 2000;Aikawa et al, 2003). Studies exist suggesting that different incidence rates for bladder cancer in male and female patients could be associated with menopausal status and hormonal factors (McGrath et al, 2006;Huang et al, 2009). Among women with persistent haematuria, prediction of high risk patients for developing bladder cancer based on the reproductive factors prior to cystoscopy would be of great benefit in the management of this neoplasm.…”