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Smoking status, usual adult occupation, and risk of recurrent urothelial bladder carcinoma: data from The Cancer Genome Atlas (TCGA) Project

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Abstract

Purpose

Tobacco smoking and occupational exposures are the leading risk factors for developing urothelial bladder carcinoma (UBC), yet little is known about the contribution of these two factors to risk of UBC recurrence. We evaluated whether smoking status and usual adult occupation are associated with time to UBC recurrence for 406 patients with muscle-invasive bladder cancer submitted to The Cancer Genome Atlas (TCGA) project.

Methods

Kaplan–Meier and Cox proportional hazard methods were used to assess the association between smoking status, employment in a high-risk occupation for bladder cancer, occupational diesel exhaust exposure, and 2010 Standard Occupational Classification group and time to UBC recurrence.

Results

Data on time to recurrence were available for 358 patients over a median follow-up time of 15 months. Of these, 133 (37.2%) experienced a recurrence. Current smokers who smoked for more than 40 pack-years had an increased risk of recurrence compared to never smokers (HR 2.1, 95% CI 1.1, 4.1). Additionally, employment in a high-risk occupation was associated with a shorter time to recurrence (log-rank p = 0.005). We found an increased risk of recurrence for those employed in occupations with probable diesel exhaust exposure (HR 1.8, 95% CI 1.1, 3.0) and for those employed in production occupations (HR 2.0, 95% CI 1.1, 3.6).

Conclusions

These findings suggest smoking status impacts risk of UBC recurrence, although several previous studies provided equivocal evidence regarding this association. In addition to the known causal relationship between occupational exposure and bladder cancer risk, our study suggests that occupation may also be related to increased risk of recurrence.

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Acknowledgements

This work was supported by the Intramural Research Program of the National Institutes of Health, NCI, Division of Cancer Epidemiology and Genetics (Z01CP010119).

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Authors and Affiliations

  1. Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, USA

    Amber N. Wilcox, Debra T. Silverman, Melissa C. Friesen, Sarah J. Locke, Noorie Hyun, Joanne S. Colt, Nathaniel Rothman, Lee E. Moore & Stella Koutros

  2. Division of Computational Bioscience, Department of Health and Human Services, Center for Information Technology, National Institutes of Health, Bethesda, MD, USA

    Daniel E. Russ

  3. Usher Institute of Population Health Sciences and Informatics, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK

    Jonine D. Figueroa

Authors
  1. Amber N. Wilcox
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  2. Debra T. Silverman
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  3. Melissa C. Friesen
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  4. Sarah J. Locke
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  5. Daniel E. Russ
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  6. Noorie Hyun
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  7. Joanne S. Colt
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  8. Jonine D. Figueroa
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  9. Nathaniel Rothman
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  10. Lee E. Moore
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  11. Stella Koutros
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Corresponding author

Correspondence to Stella Koutros.

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The authors declare that they have no conflict of interest.

Ethics approval

TCGA is a public resource and all approvals were acquired by the original study.

Informed consent

Informed consent was obtained from all individual participants included in each participating TCGA study.

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Wilcox, A.N., Silverman, D.T., Friesen, M.C. et al. Smoking status, usual adult occupation, and risk of recurrent urothelial bladder carcinoma: data from The Cancer Genome Atlas (TCGA) Project. Cancer Causes Control 27, 1429–1435 (2016). https://doi.org/10.1007/s10552-016-0821-7

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  • DOI: https://doi.org/10.1007/s10552-016-0821-7

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