Lower Risk in Parous Women Suggests That Hormonal Factors Are Important in Bladder Cancer Etiology

Davis-Dao, Carol A.; Henderson, Katherine DeLellis; Sullivan‐Halley, Jane; Ma, Hui; West, Dee W.; Xiang, Yong‐Bing; Gago‐Dominguez, Manuela; Stern, Mariana C.; Castelao, Jose E.; Conti, David V.; Pike, Malcolm C.; Bernstein, Leslie; Cortessis, Victoria K.

doi:10.1158/1055-9965.epi-11-0017

Cited by 49 publications

(72 citation statements)

References 42 publications

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“…Indeed, the findings of an animal study showed that rats treated with androgen hormones were more likely to have bladder tumors than rats treated with estrogen hormones (Reid et al, 1984). This finding, therefore, suggests that some androgenic hormones stimulate oncogenesis while estrogen hormones are protective (Davis-Dao et al, 2011). Furthermore, BC rarely occurs at the ages of 40-50; the average age of BC diagnosis is 69 in men and 71 in women (Letašiová et al, 2012).…”

Section: Resultsmentioning

confidence: 92%

Essentials of bladder cancer worldwide: incidence, mortality rate and risk factors

et al. 2017

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Bladder cancer (BC) is the sixth most common cancer in the world. An increase in the incidence and recurrence of BC has led to massive pressure on health care systems. Studies have shown that the geographical and ethical distributions of BC are variable in different parts of the world. However, most studies have focused more on clinical challenges and treatment strategies in BC management. Due to the limited number of studies conducted on the incidence rate, mortality and risk factors of BC worldwide, it is necessary to carry out studies in these areas. Therefore, the aim of this study was to determine the global incidence rate, mortality rate and risk factors for BC.

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Section: Resultsmentioning

confidence: 92%

Essentials of bladder cancer worldwide: incidence, mortality rate and risk factors

et al. 2017

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“…Mice treated with tamoxifen either before (weeks 5-8) or after (weeks 20-32) BBN exposure were also significantly larger than control bladders by 2.5-fold and 1.5-fold, respectively (Wilcoxon Rank-Sum test, P < .0005). In contrast, the average bladder weights of groups 3 and 5 that received tamoxifen concurrent to (weeks [8][9][10][11][12][13][14][15][16][17][18][19][20] or during and after (weeks 8-32) BBN were not different from control animals; rather, they were significantly smaller than the bladder weights obtained for mice exposed to BBN alone (Wilcoxon Rank-Sum test, P < .0005). Body weights were recorded at the end of 32 weeks, but there were no statistically significant differences between the groups (data not shown).…”

Section: Tamoxifen Conferred Protection Against Bbn-induced Mouse Blamentioning

confidence: 79%

“…With respect to non-muscle-invasive carcinoma, 55 μg/day tamoxifen administered concurrently with BBN (weeks [8][9][10][11][12][13][14][15][16][17][18][19][20] or during and after BBN exposure (weeks 8-32) yielded a very low level of disease, 14% and 7%, respectively, resulting in 86% and 90%, respectively, of the animals having bladders with normal histology (Figure 3). Thus, these treatment schedules were largely protective against BBN-induced bladder carcinogenesis.…”

Section: Tamoxifen Conferred Protection Against Bbn-induced Mouse Blamentioning

confidence: 99%

“…Conversely, examining bladder cancer incidence relative to reproductive events that alter exposure to estrogens and other reproductive hormones suggests that estrogens may limit risk of urothelial carcinoma in women. For instance, women who experience early menopause are at higher risk [3], while parous women have a lower risk of bladder cancer than nulliparous women [10][11][12]. In addition, use of oral contraceptives and hormone replacement therapy also has been associated with reduced bladder cancer risk [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Chemoprevention of BBN-Induced Bladder Carcinogenesis by the Selective Estrogen Receptor Modulator Tamoxifen

George¹,

Tovar-Sepulveda²,

Shen³

et al. 2011

CLINICAL/TRANSLATIONAL - Endocrine Neoplasia

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Bladder cancer is the fifth most frequent tumor in men and ninth in women in the United States. Due to a high likelihood of recurrence, effective chemoprevention is a significant unmet need. Estrogen receptors (ERs), primarily ERβ, are expressed in normal urothelium and urothelial carcinoma, and blocking ER function with selective ER modulators such as tamoxifen inhibits bladder cancer cell proliferation in vitro. Herein, the chemoprotective potential of tamoxifen was evaluated in female mice exposed to the bladder-specific carcinogen, N -butyl-N -(4-hydroxybutyl) nitrosamine (BBN). Carcinogen treatment resulted in a 76% tumor incidence and increased mean bladder weights in comparison to controls. In contrast, mice receiving tamoxifen concurrent (8-20 weeks) or concurrent and subsequent (8-32 weeks) to BBN administration had no change in bladder weight and only 10% to 14% incidence of tumors. Non-muscle-invasive disease was present in animals treated with tamoxifen before (5-8 weeks) or after (20-32 weeks) BBN exposure, while incidence of muscle-invasive bladder carcinoma was reduced. ERβ was present in all mice and thus is a potential mediator of the tamoxifen chemoprotective effect. Surprisingly, ERα expression, which was detected in 74% of the mice exposed to BBN alone but not in any control mice, was correlated with tumor incidence, indicating a possible role for this receptor in carcinogen-induced urothelial tumorigenesis. Thus, these data argue that both ERα and ERβ play a role in modulating carcinogen-induced bladder tumorigenesis. Administration of tamoxifen should be tested as a chemopreventive strategy for patients at high risk for bladder cancer recurrence.Translational Oncology (2013) 6, 244-255 IntroductionAs the fifth most common cancer in men and ninth most common in women in the United States, urinary bladder cancer accounts for significant morbidity and mortality. There are estimated to be more than 73,000 new bladder cancer cases in 2012 [1] with urothelial carcinoma accounting for approximately 90% of these; the remainder is composed of squamous cell carcinomas, adenocarcinomas, and other rare histologies [2]. Approximately 70% of all new bladder cancer cases are classified as non-muscle-invasive (Ta, T1, Tis), while the remaining 30% are muscle-invasive (T2-T4) and generally lead to cystectomy. Bladder cancer recurs at a very high rate of 50% to 90% depending on the tumor stage, grade, and number of primary tumors, and this necessitates lifetime monitoring for tumor recur-

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“…Several studies have previously investigated the effects of first or last pregnancy in early (age ≤21 years), mid (21-35 years) and late (age ≥35 years) reproductive periods on the risk of developing bladder cancer (McGrath et al, 2006;Huang et al, 2009 ;Davis-Dao et al, 2011;Dietrich et al, 2011). Wolpert et al (2010) claimed that delivering the first child after 18 years of age has been associated with reduced total amount of exposure to oestrogens in a life time and with an increased prevalence of bladder cancer.…”

Section: Discussionmentioning

confidence: 99%

Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?

Yavuzcan

Çağlar²,

Kayikçi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. Materials and Methods: A total of 463 patients underwent diagnostic cystoscopy in Düzce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Forteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. Results: Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity ≥3 (p=0.22), age ≤18 years at first delivery (p=1.00), age ≥30 years at last delivery (p=0.26), age ≥35 years at last delivery (p=0.23) and percentage of the patients with advanced age (≥65 years) (p=0.18). Conclusions: It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors.

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Lower Risk in Parous Women Suggests That Hormonal Factors Are Important in Bladder Cancer Etiology

Cited by 49 publications

References 42 publications

Essentials of bladder cancer worldwide: incidence, mortality rate and risk factors

Essentials of bladder cancer worldwide: incidence, mortality rate and risk factors

Chemoprevention of BBN-Induced Bladder Carcinogenesis by the Selective Estrogen Receptor Modulator Tamoxifen

Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?

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