Assessment of the Ecological Association between Tobacco Smoking Exposure and Bladder Cancer Incidence over the Past Half-Century in the United States

Author:

Seisen Thomas123,Labban Muhieddine12,Lipsitz Stuart R.2,Preston Mark A.1,Mossanen Matthew1,Bellmunt Joaquim4,Rouprêt Morgan3,Choueiri Toni K.4,Kibel Adam S.1,Sun Maxine4,Trinh Quoc-Dien12

Affiliation:

1. Division of Urological Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA

2. Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA

3. Department of Urology, Pitié-Salpêtrière Hospital, APHP, Sorbonne University, GRC n°5 Predictive Onco-Urology, 75013 Paris, France

4. Lank Center for Genitourinary Oncology, Dana-Farber/Brigham and Women’s Cancer Center, Harvard Medical School, Boston, MA 02115, USA

Abstract

Background: Since tobacco smoking represents the most established risk factor for bladder cancer, we sought to assess the ecological association between tobacco smoking prevalence and bladder cancer incidence and to contrast it with lung cancer. Methods: The annual overall tobacco smoking prevalence rates were extracted from the Report of the Surgeon General and the Center for Disease Control between 1953 and 1983. The overall age-adjusted incidence rates for bladder and lung cancers were derived from the Surveillance, Epidemiology, and End Results database between 1983 and 2013 (30-year latency period). Weighted least square regression models were used to assess bladder and lung cancer incidence rate differences (IRD) related to trends in tobacco smoking prevalence. A Wald test was used to compare whether the prevalence of tobacco smoking, as an explanatory variable, differentially predicts bladder versus lung cancer incidence rates. Results: The associations between tobacco smoking prevalence and bladder cancer incidence were not significant in the overall (IRD = +0.04; 95%CI (−0.14; +0.22); p = 0.63), male (IRD = +0.07; 95%CI (−0.09; +0.23); p = 0.37), or female (IRD = +0.12; 95%CI (−0.01; +0.25); p = 0.06) populations. There was an association between tobacco smoking prevalence and lung cancer incidence in the overall (IRD: +3.55; 95%CI ( +3.09; +4.00); p < 0.001), male (IRD: +4.82; 95%CI (+4.44; +5.20); p < 0.001), and female (IRD: +3.55; 95%CI (+3.12; +3.99); p < 0.001) populations. The difference between the observed associations of tobacco smoking prevalence with bladder versus lung cancer incidence was also significant in all examined populations (p < 0.001). Conclusions: Variations in tobacco smoking prevalence only partially explained the trends in the incidence of bladder cancer, indicating that its etiology is complex.

Publisher

MDPI AG

Reference43 articles.

1. Cancer statistics;Siegel;CA Cancer J. Clin.,2022

2. Secondhand smoking increases bladder cancer risk in nonsmoking population: A meta-analysis;Yan;Cancer Manag. Res.,2018

3. American Cancer Society (2022, November 09). Bladder Cancer Risk Factors. Available online: https://www.cancer.org/cancer/bladder-cancer/causes-risks-prevention/risk-factors.html#:~:text=People%20who%20smoke%20are%20at,227%2D2345%20for%20more%20information.

4. The economics of bladder cancer: Costs and considerations of caring for this disease;Svatek;Eur. Urol.,2014

5. Barber, N., and Ali, A. (2022). Urologic Cancers, Exon Publications.

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