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Body mass and smoking are modifiable risk factors for recurrent bladder cancer
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    In the Western world, bladder cancer is the fourth most common cancer in men and the eighth most common in women. Recurrences frequently occur and continued surveillance is necessary to identify and treat recurrent tumors. Efforts to identify risk factors that are potentially modifiable to reduce the rate of recurrence are needed.


    We investigated cigarette smoking behavior and body mass index (BMI) at diagnosis for associations with bladder cancer recurrence in a population-based study of 726 bladder cancer patients in New Hampshire, US. Patients diagnosed with non-muscle invasive urothelial-cell carcinoma were followed to ascertain long-term prognosis. Analysis of time to recurrence was performed using multivariate Cox regression models.


    Smokers experienced shorter time to recurrence (continuing smoker HR 1.51 95%CI 1.08-2.13). Although being overweight (BMI>24.9 kg/m2) at diagnosis was not a strong independent factor (HR 1.33 95%CI 0.94-1.89), among continuing smokers, being overweight more than doubled the risk of recurrence compared to smokers of normal weight (HR 2.67 95%CI 1.14-6.28).


    These observational results suggest that adiposity is a risk factor for bladder cancer recurrence, particularly among tobacco users. Future intervention studies are warranted to evaluate whether both smoking cessation and weight reduction strategies reduce bladder tumor recurrences.

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  • Funding:
    CA121382/CA/NCI NIH HHS/United States
    CA82354/CA/NCI NIH HHS/United States
    ES00002/ES/NIEHS NIH HHS/United States
    ES05947/ES/NIEHS NIH HHS/United States
    ES07373/ES/NIEHS NIH HHS/United States
    K07 CA102327/CA/NCI NIH HHS/United States
    K07CA102327/CA/NCI NIH HHS/United States
    P20 GM103534/GM/NIGMS NIH HHS/United States
    P20 RR018787/RR/NCRR NIH HHS/United States
    P20 RR024475/RR/NCRR NIH HHS/United States
    P30 ES000002/ES/NIEHS NIH HHS/United States
    P42 ES005947/ES/NIEHS NIH HHS/United States
    P42 ES007373/ES/NIEHS NIH HHS/United States
    R01 CA082354/CA/NCI NIH HHS/United States
    R03 CA121382/CA/NCI NIH HHS/United States
    R21 CA182659/CA/NCI NIH HHS/United States
    RR018787/RR/NCRR NIH HHS/United States
    U58/DP000798/DP/NCCDPHP CDC HHS/United States
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