We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Environmental and occupational exposures and prognosis in patients with non–muscle-invasive bladder cancer in the Be-Well Study.
- Authors
Wang, Zinian; Kwan, Marilyn L; Haque, Reina; Pratt, Rachel; Lee, Valerie S; Roh, Janise M; Ergas, Isaac J; Cannavale, Kimberly L; Loo, Ronald K; Aaronson, David S; Quesenberry, Charles P; Ambrosone, Christine B; Kushi, Lawrence H; Tang, Li
- Abstract
Bladder cancer is primarily diagnosed as non–muscle-invasive bladder cancer (NMIBC), with high recurrence and progression rates. Environmental and occupational exposures to carcinogens are well-known risk factors for developing bladder cancer, yet their effects on prognosis remain unknown. In the Be-Well Study, a population-based prospective cohort study of 1472 Kaiser Permanente patients newly diagnosed with NMIBC in California from 2015 to 2019, we examined history of environmental and occupational exposures in relation to tumor stage and grade at initial diagnosis by multivariable logistic regression, and subsequent recurrence and progression by Cox proportional hazards regression. Exposure to environmental and occupational carcinogens was significantly associated with increased risk of progression (hazard ratio (HR) = 1.79; 95% CI, 1.04-3.09), specifically with increased progression to muscle-invasive disease (HR = 2.28; 95% CI, 1.16-4.50). Exposures to asbestos and arsenic were associated with increased odds of advanced stage at diagnosis (asbestos: odds ratio (OR) = 1.43 [95% CI, 1.11-1.84]; arsenic: OR = 1.27 [95% CI, 1.01-1.63]), and formaldehyde exposure was associated with increased risk of recurrence (HR = 1.38; 95% CI, 1.12-1.69). Our findings suggest that considering a patient's history of these exposures may benefit current risk stratification systems in better tailoring clinical care and improving prognosis among patients with NMIBC.
- Subjects
CALIFORNIA; NON-muscle invasive bladder cancer; RISK assessment; POPULATION-based case control; CANCER relapse; RESEARCH funding; LOGISTIC regression analysis; TUMOR grading; MULTIVARIATE analysis; LONGITUDINAL method; ODDS ratio; OCCUPATIONAL exposure; FORMALDEHYDE; TUMOR classification; DISEASE relapse; CONFIDENCE intervals; ARSENIC; DISEASE progression; PROPORTIONAL hazards models; ASBESTOS
- Publication
American Journal of Epidemiology, 2024, Vol 193, Issue 6, p863
- ISSN
0002-9262
- Publication type
Article
- DOI
10.1093/aje/kwad236