Background: Controversy exists on whether urinary tract infection (UTI) is a risk factor for urinary bladder cancer (UBC).
Here, the association is investigated using data from one of the largest bladder cancer case-control studies worldwide.
Methods: Information on (i) history and age at onset of regular cystitis ('regular low-UTI') and (ii) number and age at onset of UTI treated with antibiotics ('UTI-ab') from 1809 UBC patients and 4370 controls was analysed. Odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, education, smoking, and use of aspirin/ibuprofen were generated, for men and women separately.
Results: Regular low-UTI was associated with an increased UBC risk (men: OR (95% CI) 6.6 (4.2-11); women: 2.7 (2.0-3.5)), with stronger effects in muscle-invasive UBC. Statistically significant decreased risks (ORs ∼0.65) were observed for up to five UTI-ab, specifically in those who (had) smoked and experienced UTI-ab at a younger age. In women, UTI experienced after menopause was associated with a higher UBC risk, irrespective of the number of episodes.
Conclusions: Regular cystitis is positively associated with UBC risk. In contrast, a limited number of episodes of UTI treated with antibiotics is associated with decreased UBC risk, but not in never-smokers and postmenopausal women.
Vermeulen SH, Hanum N, Grotenhuis AJ, Castaño-Vinyals, van der Heijden AG4, Aben KK, Mysorekar IU, Kiemeney LA. Are you the author?
Department for Health Evidence & Department of Human Genetics, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Department for Health Evidence, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, E-08003 Barcelona, Spain; Department of Urology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Comprehensive Cancer Centre the Netherlands, 3511 GD Utrecht, The Netherlands; Departments of Obstetrics & Gynecology, Pathology & Immunology, Washington University School of Medicine, 660S. Euclid Avenue, St. Louis MO 63110, USA; Department for Health Evidence & Department of Urology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Reference: Br J Cancer. 2014 Nov 27. Epub ahead of print.