The Effect of Histology and Smoking on Treatment Outcomes of Urinary Bladder Cancer

Signature Grand, Davie, Florida, USA

Objective. The objective of this study was to compare the effects of histology and smoking on treatment outcomes of urinary bladder cancer. Background. Urinary bladder cancer is the fourth most common cancer in men and the eighth most common cancer in women. The two most frequent histological types are the urothelial and papillary carcinomas. Studies have shown that age, smoking (tobacco), and treatment types are risk factors for urinary bladder cancer. Methods. The study had 28,162 incident cases of patients with urinary bladder, between January 1st, 1994 and December 31st, 2002, based on the Florida Cancer Registry. The stratified Mantel-Haenszel method was used in this routine database that was similar to a cross-sectional study. The selection of cancer incident cases allowed for the use of relative risk (RR) as a measure of association between the vital status (dead or alive) and treatment type: surgery (SR) vs. surgery+chemotherapy+other adjuvant therapy (SR+CT+ADJ). Results. Histology was found to be a confounder. We also found that smoking was an effect modifier when controlling for histology. Patients who smoke and were diagnosed with urothelial carcinoma were 32% more likely to be at risk of dying than nonsmokers with the same histology. Among the patients treated with SR+CT+ADJ, 19% of the failures were attributed to smoking. Conclusions. Smoking greatly affects the treatment outcomes of urinary bladder cancer. SR+CT+AD is concluded as a more risky choice for treatment of patients with urothelial carcinoma who smoke compared to surgery alone. Grants and Acknowledgement. This study was funded in part through the HPD Research Grant for Florida Cancer Registry Analysis, 2004-2007. The views expressed herein are solely those of the authors and do not necessarily reflect those of FCDS, the contractor of FL-DOH.