BACKGROUND: It is important to understand the adverse health sequelae that may result from the rising incidence of diabetes. Diabetics may have an increased risk for urothelial cancer but the evidence from prospective studies and ethnically diverse populations is sparse. METHOD: We examined this association in the Multiethnic Cohort (MEC) that was conducted in Hawaii and Los Angeles with nearly 186,000 participants in five ethnic groups. Over a median 10.7 years of follow-up, 918 incident cases of urothelial cancer (89% bladder and 11% other urinary tract sites) were identified through tumor registry linkages. RESULTS: A self-reported diagnosis of diabetes was associated with an increased risk of urothelial cancer (relative risk=1.25; 95% confidence interval: 1.04-1.50). The association was not explained by body mass index, physical activity, or smoking. There was some suggestion that the risk was higher in women, Whites and African Americans, and past smokers. The risk associated with diabetes for in situ and localized cancer was similar to that for regional and distant cancer. CONCLUSION: This study demonstrates that the increased urothelial cancer risk with diabetes in this multiethnic population is very similar to that observed in mostly White or Asian populations. Whether or not the elevated risk is moderated by the degree of control of the hyperglycemia associated with diabetes will need to be determined in future studies.
BACKGROUND: It is important to understand the adverse health sequelae that may result from the rising incidence of diabetes. Diabetics may have an increased risk for urothelial cancer but the evidence from prospective studies and ethnically diverse populations is sparse. METHOD: We examined this association in the Multiethnic Cohort (MEC) that was conducted in Hawaii and Los Angeles with nearly 186,000 participants in five ethnic groups. Over a median 10.7 years of follow-up, 918 incident cases of urothelial cancer (89% bladder and 11% other urinary tract sites) were identified through tumor registry linkages. RESULTS: A self-reported diagnosis of diabetes was associated with an increased risk of urothelial cancer (relative risk=1.25; 95% confidence interval: 1.04-1.50). The association was not explained by body mass index, physical activity, or smoking. There was some suggestion that the risk was higher in women, Whites and African Americans, and past smokers. The risk associated with diabetes for in situ and localized cancer was similar to that for regional and distant cancer. CONCLUSION: This study demonstrates that the increased urothelial cancer risk with diabetes in this multiethnic population is very similar to that observed in mostly White or Asian populations. Whether or not the elevated risk is moderated by the degree of control of the hyperglycemia associated with diabetes will need to be determined in future studies.
Authors: Jeanette S Brown; Hunter Wessells; Michael B Chancellor; Stuart S Howards; Walter E Stamm; Ann E Stapleton; William D Steers; Stephen K Van Den Eeden; Kevin T McVary Journal: Diabetes Care Date: 2005-01 Impact factor: 19.112
Authors: Margaret E Wright; Dominique S Michaud; Pirjo Pietinen; Philip R Taylor; Jarmo Virtamo; Demetrius Albanes Journal: Cancer Causes Control Date: 2005-11 Impact factor: 2.506
Authors: L N Kolonel; B E Henderson; J H Hankin; A M Nomura; L R Wilkens; M C Pike; D O Stram; K R Monroe; M E Earle; F S Nagamine Journal: Am J Epidemiol Date: 2000-02-15 Impact factor: 4.897
Authors: Steven S Coughlin; Eugenia E Calle; Lauren R Teras; Jennifer Petrelli; Michael J Thun Journal: Am J Epidemiol Date: 2004-06-15 Impact factor: 4.897
Authors: Gertraud Maskarinec; Eva Erber; Andrew Grandinetti; Martijn Verheus; Robert Oum; Beth N Hopping; Mark M Schmidt; Aileen Uchida; Deborah Taira Juarez; Krista Hodges; Laurence N Kolonel Journal: Diabetes Date: 2009-03-03 Impact factor: 9.461
Authors: Song-Yi Park; Nicholas J Ollberding; Christy G Woolcott; Lynne R Wilkens; Brian E Henderson; Laurence N Kolonel Journal: J Nutr Date: 2013-06-05 Impact factor: 4.798
Authors: Bartosz Dybowski; Krzysztof Ossoliński; Anna Ossolińska; Michał Peller; Ewa Bres-Niewada; Piotr Radziszewski Journal: Cent European J Urol Date: 2015-10-15