Diabetes mellitus and non‐muscle‐invasive bladder cancer: not just a coincidence?

Abstract

[2] shows a high NPV only when the threshold was set at the low level of 2 for each parameter. Predictably, at this threshold the PPV was extremely low, and therefore many men would still undergo unnecessary biopsy. Another similar paper advocated a mean threshold of 3, but even then the PPV was 38% with a NPV of 95% [3]. Both these papers are retrospective studies, in particular the MRI readings were done retrospectively. Nevertheless, the low PPV is disappointing. The results of prospective studies with multiple readers are keenly awaited and I hope that that these will find a higher PPV for mpMRI, and we can to move to an era when fewer men undergo needless prostate biopsy.

Diabetes Mellitus and Obesity as Risk Factors for Bladder Cancer Prognosis: A Systematic Review and Meta-Analysis

“…involved, as chronic hyperinsulinemia or hyperglycemia has been shown to promote tumor cell proliferation and metastasis (44)(45)(46)(47). Similarly, elevated levels of insulin-like growth factor (IGF)-1 induces cellular proliferation while inhibiting apoptosis (44)(45)(46)(47). Excess adiposity also creates a pro-inflammatory environment, and this may contribute to poorer prognostic outcomes in cancers.…”

Association between diabetes mellitus and oncological outcomes in bladder cancer patients undergoing radical cystectomy

“…However, the exact mechanisms responsible for this association are unclear . Postulated mechanisms include the effects of hyperinsulinemia, hyperglycemia and signal pathways of insulin‐like growth factor receptors . Regardless of an unknown mechanism, several large‐scale epidemiology studies showed a significant association between DM and UBC.…”

Metabolic syndrome and common urological conditions: looking beyond the obvious

“…There has been extensive work to try to identify a link between bladder cancer and type 2 diabetes, with some studies suggesting an increased riskhowever, again, potential confounders exist, as the diabetic population is more likely to have regular urine testing, which may account for a higher incidence of bladder cancer. 35 DIABETES AND METABOLIC SYNDROME 31 TESTICULAR CANCER Testicular cancer patients have an increased risk for CVD, which might be related to the increased prevalence of the metabolic syndrome in this group of patients. 36 A recent study assessed the prevalence of metabolic syndrome and the 10-year CVD risk in a cohort of 255 testicular germ cell tumour survivors (median age, 38.7 years; interquartile range, 31-48) at a mean of 7.8 years after anticancer treatment, and compared these with data obtained from 360 healthy men.…”