Positive association between hypertension and urinary bladder cancer: epidemiologic evidence involving 79,236 propensity score-matched individuals

Abstract

IntroductionWe hypothesized that hypertensive patients harbor a higher risk of urinary bladder (UB) cancer.Material and methodsWe performed a population-based cohort study on adults using a National Health Insurance Research Database (NHIRD) dataset. Hypertension and comparison non-hypertensive (COMP) groups comprising 39,618 patients each were propensity score-matched by age, sex, index date, and medical comorbidities. The outcome was incident UB cancer validated using procedure codes. We constructed multivariable Cox models to derive adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Cumulative incidence was compared using a log-rank test.ResultsDuring a total follow-up duration of 380,525 and 372,020 person-years in the hypertension and COMP groups, 248 and 186 patients developed UB cancer, respectively, representing a 32% increase in the risk (aHR, 1.32; 95% CI, 1.09–1.60). Hypertensive women harbored a significantly increased risk of UB cancer (aHR, 1.55; 95% CI, 1.12–2.13) compared with non-hypertensive women, whereas men with hypertension had a statistically non-significant increased risk (aHR, 1.22; 95% CI, 0.96–1.55). The sensitivity analysis demonstrated that the increased risk was sustained throughout different follow-up durations for the entire cohort; a statistical increase in the risk was also noted among hypertensive men.ConclusionThis nationwide population-based propensity score-matched cohort study supports a positive association between hypertension and subsequent UB cancer development.

Blood pressure and bladder cancer risk in men by use of survival analysis and in interaction with NAT2 genotype, and by Mendelian randomization analysis

“…with findings from the conventional analysis in this and our previous, larger study [5], and in some other previous observational studies [6][7][8]. However, the association may also be driven by low study power and pleiotropy.…”

“…We recently reported epidemiologic support of this hypothesis in a large prospective study that showed a positive association between BP and BC risk, but only among men [5]. Other observational studies of BP and BC risk have shown conflicting results, with some studies showing a positive association [5][6][7][8], and others showing no association [2,[9][10][11], altogether resulting in null results in a meta-analysis that included studies predating our previous study [9]. However, most included studies were hampered by limited sample size and a combined analysis of men and women, who could have different risk profiles as indicated by the results in our study [5] and by the substantially higher BC incidence among men than among women [5,12].…”

Prognostic value of hypertension in patients with nasopharyngeal carcinoma treated with intensity-modulated radiation therapy

“…With an occurrence rate of 37%, hypertension has been reported to be the most common comorbidity encountered in patients with tumors (4). Many studies have suggested that hypertension is associated with an increased risk of cancer, such as renal cell carcinoma (5), breast cancer (6), and urinary bladder cancer (7). In addition, renal cancer (8), pancreatic cancer (9), and esophageal cancer patients (10) with hypertension have poorer prognoses than normotensive patients.…”

Combination role of DAPK methylation in urinary sediment and B ultrasound in evaluating follow-up of urinary bladder cancer

“…Urinary bladder cancer (UBC) is one of the most prevalent cancers in the world with an estimated 430,000 new cases diagnosed in 2012, ranking the sixth most common cancer in the United States with an approximately 74,690 new cases diagnosed in the years of 2014 [1,2]. UBC is more likely to be primarily diagnosed in individuals older than 65 years and the incidence occurred in those older than 70 years is sevenfold to tenfold [3].…”