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Obesity and Risk of Bladder Cancer: A Meta-analysis of Cohort Studies

  • Qin, Qi (Department of General Surgery, Childrens Hospital, Zhejiang University School of Medicine) ;
  • Xu, Xin (Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine) ;
  • Wang, Xiao (Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine) ;
  • Zheng, Xiang-Yi (Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine)
  • Published : 2013.05.30

Abstract

Objective: Previous epidemiologic studies demonstrated that obesity might associated with the risk of bladder cancer. However, many of the actual association findings remained conflicting. To better clarify and provide a comprehensive summary of the correlation between obesity and bladder cancer risk, we conducted a meta-analysis to summarize results of studies on the issue. Stratified analyses were also performed on potential variables and characteristics. Methods: Studies were identified by searching in PubMed and Wanfang databases, covering all the papers published from their inception to March 10, 2013. Summary relative risks (SRRs) with their corresponding 95% confidence intervals (CIs) were calculated by either random-effect or fixed-effect models. Results: A total of 11 cohort studies were included in our meta-analysis, which showed that obesity was associated with an increased risk for bladder cancer in all subjects (RR=1.10, 95% CI=1.06-1.16; p=0.215 for heterogeneity; $I^2$=24.0%). Among the 9 studies that controlled for cigarette smoking, the pooled RR was 1.09 (95% CI 1.01-1.17; p=0.131 for heterogeneity; $I^2$=35.9%). No significant publication bias was detected (p = 0.244 for Egger's regression asymmetry test). Conclusions: Our results support the conclusion that obesity is associated with the increased risk of bladder cancer. Further research is needed to generate a better understanding of the correlation and to provide more convincing evidence for clinical intervention in the prevention of bladder cancer.

Keywords

Obesity;bladder cancer;risk;meta-analysis;smoking;confounding factor

References

  1. Begg CB, Mazumdar M (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50, 1088-101. https://doi.org/10.2307/2533446
  2. Chen HS, Su LT, Lin SZ, et al (2012). Increased risk of urinary tract calculi among patients with diabetes mellitus--a population-based cohort study. Urology, 79, 86-92. https://doi.org/10.1016/j.urology.2011.07.1431
  3. Chow WH, Lindblad P, Gridley G, et al (1997). Risk of urinary tract cancers following kidney or ureter stones. J Natl Cancer Inst, 89, 1453-7. https://doi.org/10.1093/jnci/89.19.1453
  4. DerSimonian R, Laird N(1986). Meta-analysis in clinical trials. Control Clin Trials, 7, 177-88. https://doi.org/10.1016/0197-2456(86)90046-2
  5. Dunn SE, Kari FW, French J, et al (1997). Dietary restriction reduces insulin-like growth factor I levels, which modulates apoptosis, cell proliferation, and tumor progression in p53-deficient mice. Cancer Res, 57, 4667-72.
  6. Egger M, Davey Smith G, Schneider M, Minder C (1997). Bias in meta-analysis detected by a simple, graphical test. BMJ, 315, 629-34. https://doi.org/10.1136/bmj.315.7109.629
  7. Flegal KM, Graubard BI, Williamson DF, Gail MH (2005). Excess deaths associated with underweight, overweight, and obesity. JAMA, 293, 1861-7. https://doi.org/10.1001/jama.293.15.1861
  8. Funfstuck R, Nicolle LE, Hanefeld M, Naber KG (2012). Urinary tract infection in patients with diabetes mellitus. Clin Nephrol, 77, 40-8. https://doi.org/10.5414/CN107216
  9. Haggstrom C, Stocks T, Rapp K, et al (2011). Metabolic syndrome and risk of bladder cancer: prospective cohort study in the metabolic syndrome and cancer project (Me-Can). Int J Cancer, 128, 1890-8. https://doi.org/10.1002/ijc.25521
  10. Jankovic S, Radosavljevic V (2007). Risk factors for bladder cancer. Tumori, 93, 4-12.
  11. Jee SH, Yun JE, Park EJ, et al (2008). Body mass index and cancer risk in Korean men and women. Int J Cancer, 123, 1892-6. https://doi.org/10.1002/ijc.23719
  12. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  13. Jones ME, Swerdlow AJ (1998). Bias in the standardized mortality ratio when using general population rates to estimate expected number of deaths. Am J Epidemiol, 148, 1012-7. https://doi.org/10.1093/oxfordjournals.aje.a009567
  14. Key TJ, Appleby PN, Reeves GK, Roddam AW(2010). Insulinlike growth factor 1 (IGF1), IGF binding protein 3 (IGFBP3), and breast cancer risk: pooled individual data analysis of 17 prospective studies. Lancet Oncol, 11, 530-42. https://doi.org/10.1016/S1470-2045(10)70095-4
  15. Koebnick C, Michaud D, Moore SC, et al (2008). Body mass index, physical activity, and bladder cancer in a large prospective study. Cancer Epidemiol Biomarkers Prev, 17, 1214-21. https://doi.org/10.1158/1055-9965.EPI-08-0026
  16. Larsson SC, Andersson SO, Johansson JE, Wolk A (2008). Diabetes mellitus, body size and bladder cancer risk in a prospective study of Swedish men. Eur J Cancer, 44, 2655-60. https://doi.org/10.1016/j.ejca.2008.07.012
  17. Mantel N, Haenszel W(1959). Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst, 22, 719-48.
  18. Murta-Nascimento C, Schmitz-Drager BJ, Zeegers MP, et al (2007). Epidemiology of urinary bladder cancer: from tumor development to patient's death. World J Urol, 25, 285-95. https://doi.org/10.1007/s00345-007-0168-5
  19. Rinaldi S, Cleveland R, Norat T, et al (2010). Serum levels of IGF-I, IGFBP-3 and colorectal cancer risk: results from the EPIC cohort, plus a meta-analysis of prospective studies. Int J Cancer, 126, 1702-15.
  20. Siegel R, Naishadham D, Jemal A (2013). Cancer statistics, 2013. CA Cancer J Clin, 63, 11-30. https://doi.org/10.3322/caac.21166
  21. Zhao H, Grossman HB, Spitz MR, et al (2003). Plasma levels of insulin-like growth factor-1 and binding protein-3, and their association with bladder cancer risk. J Urol, 169, 714-7. https://doi.org/10.1016/S0022-5347(05)63999-7

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