Journal Article

Smoking status, usual adult occupation, and risk of recurrent urothelial bladder carcinoma

Friesen, Melissa C., Hyun, Noorie, Wilcox, Amber N., Koutros, Stella, Russ, Daniel E., Silverman, Debra T., Moore, Lee E., Colt, Joanne S., Locke, Sarah J., Rothman, Nathaniel, Figueroa, Jonine D.

2016

Overview

Purpose Tobacco smoking and occupational exposures are the leading risk factors for developing urothelial bladder carcinoma (UBC), yet little is known about the contribution of these two factors to risk of UBC recurrence. We evaluated whether smoking status and usual adult occupation are associated with time to UBC recurrence for 406 patients with muscle-invasive bladder cancer submitted to The Cancer Genome Atlas (TCGA) project. Methods Kaplan–Meier and Cox proportional hazard methods were used to assess the association between smoking status, employment in a high-risk occupation for bladder cancer, occupational diesel exhaust exposure, and 2010 Standard Occupational Classification group and time to UBC recurrence. Results Data on time to recurrence were available for 358 patients over a median follow-up time of 15 months. Of these, 133 (37.2%) experienced a recurrence. Current smokers who smoked for more than 40 pack-years had an increased risk of recurrence compared to never smokers (HR 2.1, 95% CI 1.1, 4.1). Additionally, employment in a high-risk occupation was associated with a shorter time to recurrence (log-rank p  = 0.005). We found an increased risk of recurrence for those employed in occupations with probable diesel exhaust exposure (HR 1.8, 95% CI 1.1, 3.0) and for those employed in production occupations (HR 2.0, 95% CI 1.1, 3.6). Conclusions These findings suggest smoking status impacts risk of UBC recurrence, although several previous studies provided equivocal evidence regarding this association. In addition to the known causal relationship between occupational exposure and bladder cancer risk, our study suggests that occupation may also be related to increased risk of recurrence.

• Publisher: Springer Science + Business Media,Springer International Publishing,Springer Nature B.V
• Subject: Aged / Biomedical and Life Sciences / Biomedicine / Bladder cancer / Cancer Research / Employment / Epidemiology / Female / Genomes / Hematology / Humans / Male / Middle Aged / Neoplasm Recurrence, Local - epidemiology / Neoplasm Recurrence, Local - genetics / Neoplasm Recurrence, Local - pathology / Occupational Exposure - statistics & numerical data / Occupations / Occupations - statistics & numerical data / Oncology / ORIGINAL PAPER / Patients / Public Health / Risk Factors / Smoking / Smoking - adverse effects / Smoking - epidemiology / Smoking - genetics / Smoking - pathology / Tobacco / United States - epidemiology / Urinary Bladder Neoplasms - epidemiology / Urinary Bladder Neoplasms - genetics / Urinary Bladder Neoplasms - pathology