Body Size and Bladder Cancer Risk: A Pooled Analysis of Prospective Studies From the National Cancer Institute Cohort Consortium
Abstract
PURPOSE Body size is an established risk factor for several cancers, but associations with bladder cancer risk remain unclear. METHODS We pooled data from 2,533,008 participants in 30 international cohort studies to assess associations of BMI, waist circumference, and height with bladder cancer risk. Multivariable Cox regression models, including smoking status, duration, and other confounders, were run separately by cohort and sex, and results combined by random-effects meta-analysis. RESULTS Incident first primary bladder cancer was diagnosed in 15,259 males and 5,188 females. For males, overweight (BMI, 25.0-29.9 kg/m 2 ) and obesity (BMI, ≥30 kg/m 2 ) were associated with increased risk of bladder cancer, with hazard ratios (HRs) of 1.08 (95% CI, 1.04 to 1.12) and 1.16 (95% CI, 1.10 to 1.22), respectively, when compared with normal weight (BMI, 18.5-24.9 kg/m 2 ). The corresponding HR for females were 1.02 (95% CI, 0.95 to 1.09) and 1.04 (95% CI, 0.95 to 1.14), respectively. The HR per 5 kg/m 2 increment was 1.07 (95% CI, 1.05 to 1.09) for males and 1.00 (95% CI, 0.97 to 1.04) for females. Higher waist circumference was also associated with increased risk of bladder cancer for males (HR per 10 cm increase 1.06 [95% CI, 1.03 to 1.08]) but not females (HR, 1.01 [95% CI, 0.97 to 1.04]). Results for height were largely consistent with those for BMI and waist circumference, with strong and consistent evidence for males, but not females. CONCLUSION Larger body size is associated with increased risk of bladder cancer for males, but not females. Public health interventions to prevent overweight and obesity, along with smoking cessation and reduced occupational exposure to bladder carcinogens, are likely to reduce bladder cancer incidence worldwide.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (71)
Nina Afshar
Stella Koutros
Molin Wang
Harvard T.H. Chan, Boston, Massachusetts, United States
Piet A. van den Brandt
Alicja Wolk
Hans-Olov Adami
Agneta Åkesson
Matt J. Barnett
Kimberly A. Bertrand
Hui Cai
Florence Le Calvez-Kelm
Chu Chen
Mridul Datta
A. Heather Eliassen
Jo L. Freudenheim
Gretchen L. Gierach
Edward Giovannucci
Mayo Hirabayashi
Brian Z. Huang
Wen-Yi Huang
Victoria A. Kirsh
Woon-Puay Koh
James V. Lacey
Susanna C. Larsson
Linda M. Liao
Chaoran Ma
Maria Elena Martinez
Amy E. Millen
Steven C. Moore
Lorelei A. Mucci
Heather M. Munro
Marian L. Neuhouser
Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington
Heather M. Ochs-Balcom
Julie R. Palmer
Song-Yi Park
Alpa V. Patel
Population Science American Cancer Society Atlanta Georgia USA
Jessica L. Petrick
Elizabeth A. Platz
Mark A. Preston
Anna Prizment
Samantha Rees
Fulvio Ricceri
Kim Robien
Thomas E. Rohan
Sven Sandin
Norie Sawada
Eva S. Schernhammer
Marissa M. Shams-White
Martha J. Shrubsole
Xiao-Ou Shu
Rashmi Sinha
Guri Skeie
Rachael Z. Stolzenberg-Solomon
Mingyang Song
State Key Laboratory for Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, 1239 Siping Road, Shanghai 200092, China
Caroline Y. Um
Kala Visvanathan
Mara Z. Vitolins
Sophia Wang
Department of Mechanical and Aerospace Engineering, University of California Los Angeles
Eleanor L. Watts
Elisabete Weiderpass
Emily White
Walter C. Willett
Gong Yang
Jian-Min Yuan
Xuehong Zhang
Wei Zheng
Nathaniel Rothman
Brigid M. Lynch
Baker Heart and Diabetes Institute, Melbourne, Australia (H.T.D., N.J.S., T.I., C.J.B., D.W.D., N.O., B.M.L., E.J.H.).
Debra T. Silverman
Stephanie A. Smith-Warner
Roger L. Milne