Urothelial Cancer and the Diagnosis of Subsequent Malignancies

Abstract

08-7.04). Overall, the risk was similar between the sexes (female SIR: 1.30, CI 1.09-1.54; males 1.42, CI 1.31-1.54; males excluding prostate SIR: 1.22 CI 1.11-1.35). There was an increased relative risk for developing a second primary for cancers of the kidney (male), lung, breast (female) and prostate. Papillary cancers were associated with increased relative risk of developing lung, prostate, and breast (female and male) cancer. In the competing risks model, patients diagnosed with a papillary or in situ urothelial cancer were more likely to be diagnosed with a second primary than non-papillary and invasive disease, respectively. Conclusions: Those diagnosed with urothelial cancer have an increased probability of having a second primary cancer detected within the subsequent 5 years, even when prostate cancer is excluded. Papillary tumours in particular may provide a warning for subsequent malignancy.

The Risk of Colorectal Cancer Is Not Increased after a Diagnosis of Urothelial Cancer: A Population-Based Study

“…Specific sites with an increased incidence after uca included lung, prostate, and second uca. That observation is in keeping with earlier data from our institution 21 and with data from other studies 19,20 . Although it was not the primary goal of the present study to examine the risk of all cancers after a diagnosis of uca, the fact that the results of our analysis are congruent with findings in earlier studies provides confidence about the validity of our results.…”

“…Those results agree with findings in some earlier studies 19,20 , including one from our institution 21 , and contrast with the findings in a U.S. Surveillance, Epidemiology, and End Results database study demonstrating an increase in crc incidence after a diagnosis of uca 22 . None of the earlier studies used a competing risks analysis.…”

“…Data about the incidence of crc after a diagnosis of uca are mixed, with some studies demonstrating no increased incidence [19][20][21] , and one study demonstrating an increased incidence [standardized incidence ratio (sir) for colon cancer in women: 1.76; 95% confidence interval (ci): 1.44 to 2.15; sir for colon cancer in men: 1.21; 95% ci: 1.09 to 1.34; sir for rectal cancer in women: 1.67; 95% ci: 1.25 to 2.24; sir for rectal cancer in men: 1.22; 95% ci: 1.06 to 1.41] 22 . All prior studies, including one from our own institution 21 are limited, given that they have not adjusted the risk estimates for competing events such as other cancer diagnoses and death. In addition, the studies from cancer registries alone are unable to adjust for other confounding factors such as increased exposure to lower gastrointestinal endoscopy and health care visits by cancer survivors.…”