The metabolic syndrome is associated with the risk of urothelial carcinoma from a health examination database

Int J Clin Oncol. 2021 Mar;26(3):569-577. doi: 10.1007/s10147-020-01834-3. Epub 2020 Nov 24.

Abstract

Purpose: The metabolic syndrome was associated with bladder cancer in the previous studies. However, there have no large-scale cohort studies to elucidate the relationship between metabolic syndromes and urothelial carcinoma including urinary bladder urothelial carcinoma (UBUC) and upper tract urothelial carcinoma (UTUC).

Methods: We analyze a population-based cohort study by using physical examination data and diagnosis of UC from the Taiwan Cancer Registry Database. Differences in demographic and clinical characteristics among UTUC and non-UTUC groups, UBUC and non-UBUC groups were compared. Odds ratios (ORs) for determining risk factors were estimated through the multiple logistic regression model.

Results: A total of 557,063 records for 211,319 participants which consisted of 31 UTUC and 309 UBUC met the eligibility criteria in this study. Our results showed that female are more likely to develop UTUC than male. As opposed to UTUC, male are more likely to develop UBUC than female. It also showed that participants smoked or chewed betel quid daily are more likely to develop UBUC. Age and estimated glomerular filtration rate (eGFR) are significantly increased the risk of developing UTUC. The association between the eGFR and risk of UTUC is stronger (P < 0.001) for eGFR < 45 (vs. eGFR ≥ 75, OR = 6.795; 95% CI 2.901-15.917). Metabolic syndrome is related to higher risk of UBUC incidence [OR was 1.373 (95% CI 1.104-1.707)].

Conclusions: There was a significant relationship between the incidence of UBUC and metabolic syndrome. Renal function impairment presents higher risk in both UBUC and UTUC development.

Keywords: Betel quid; Metabolic syndrome; Renal function; Smoking; Urothelial carcinoma.

MeSH terms

  • Carcinoma, Transitional Cell*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Metabolic Syndrome* / complications
  • Metabolic Syndrome* / epidemiology
  • Prognosis
  • Taiwan / epidemiology