Risk of Urinary Tract Carcinoma among Subjects with Bladder Pain Syndrome/Interstitial Cystitis: A Nationwide Population-Based Study

Abstract

Objective To investigate the subsequent risks of urinary tract cancers among individuals with bladder pain syndrome/interstitial cystitis (BPS/IC), and gender differences, as well as the effect of associated comorbidity using a population-based administrative database in Taiwan. Patients and Methods BPS/IC subjects (10192) and their age- and sex-matched non-BPS/IC control subjects (30576), who had no previous upper urinary tract cancer (UUC), bladder cancer (BC), and prostate cancer (PC), subsequently developed these disorders from the recruited date between 2002 and 2008 and the end of follow-up 2011. A Cox proportional hazards regression model was constructed to estimate the risk of subsequent UUC, BC, and PC following a diagnosis of IC/BPS. The effect of associated comorbidities was measured by Charlson Comorbidity Index (CCI). The risk of outcomes was assessed with Kaplan-Meier curves. Results In the BPS/IC subjects, 37 (0.36%) received a diagnosis of BC, and 22 (0.22%) received a diagnosis of UUC; both were significantly higher than the control group, 19 (0.06%) for BC and 30 (0.10%) for UUC. Cox proportional analysis revealed that the adjusted HR for BC and UUC during the follow-up period for patients with IC/BPS was 5.44 (95% CI: 3.10-9.54) and 1.97 (95% CI: 1.13-3.45) than that of comparison subjects. The HRs went up to 5.66 (95% CI: 3.21-9.99) and 2.01 (95% CI: 1.14-3.55) after adjusted by Comorbidity Index (CCI). The male BPS/IC patients have a higher adjusted HR for BC; however, female patients have a higher adjusted HR for both BC and UUC. The adjusted HR for PC has no difference between BPS/IC and control group. Conclusion Patients with BPS/IC are at risk of developing BC in both males and females, and UUC in females. This result reminds physicians to evaluate the potential risk of subsequent development of BC and UUC among individuals with BPS/IC.

Risks of interstitial cystitis among patients with systemic lupus erythematosus: A population‐based cohort study

“…It means that cystoscopy has been carried out with findings of either glomerulation or the presence of Hunner's lesion. Therefore, we were confident that those patients diagnosed with IC by using the ICD‐9 code and who presented typical compatible cystoscopic findings were included in the present study . Different subtypes of IC have been identified, such as ulcer type, which might have distinct characteristics and underlying pathophysiology .…”

“…Therefore, there was little possibility for anyone without a clear diagnosis of IC being eligible. The same methods for the enrollment of IC have already been applied in several published studies …”

Interstitial cystitis/bladder pain syndrome patient is associated with subsequent increased risks of outpatient visits and hospitalizations: A population-based study

“…Similarly, Ueda et al indicated that IC/BPS is a common comorbidity among patients with refractory chronic prostatitis/chronic pelvic pain syndrome [ 18 ]. Additionally, a recent study of ours showed that IC/BPS patients are at risk of developing urinary tract cancer at later years [ 9 ].…”

“…This study was based on data from National Health Insurance Research Database (NHIRD) in Taiwan. The detailed information of NHIRD was described in our previous report [ 9 ]. Briefly, the NHI system was implemented from 1995 and has covered almost all population (98%) in Taiwan by the compulsory and universal health insurance.…”

“…Its provision included the presence of glomerulation or Hunner’s lesions under cystoscopy after hydrodistention test, voiding diary, negative urine cytology, and urine analysis. The same methods for the enrollment of IC/BPS patients have already been applied in a previous study of ours and other published studies [ 9 , 10 ].…”