World Journal of Urology

, Volume 37, Issue 11, pp 2393–2400 | Cite as

Association of body mass index with bladder cancer risk in men depends on abdominal obesity

  • Jin Bong Choi
  • Jung Ho Kim
  • Sung-Hoo Hong
  • Kyung-Do Han
  • U-Syn HaEmail author
Original Article



The previous epidemiological studies about the associations between obesity and bladder cancer risk have reported inconsistent results. Therefore, we analyzed whether the abdominal obesity effected on the risk of developing bladder cancer according to body mass index (BMI) using nationally representative data from the National Health Insurance System (NHIS).

Patients and methods

Among people who underwent at least one health examination from 2009 to 2012 in Korea, 11,823,876 men without a previous diagnosis of bladder cancer were followed up until December 2015. Multiple Cox regression analysis was conducted to determine the hazard ratio (HR) and 95% confidence interval (CI) for the association between bladder cancer and BMI or waist circumference (WC).


Significant upward trends in the risk of bladder cancer were observed with increasing BMI or WC according to the multivariate-adjusted model. However, the association between BMI and bladder cancer is influenced by the presence of abdominal obesity. In the group with WC < 90 cm, there was no significant change in the HRs for bladder cancer development beyond the reference BMI. In contrast, the HRs for bladder cancer showed statistically significant increase as the BMI increased beyond the reference BMI in the group with WC ≥ 90 cm.


This population-based study showed that increasing BMI and increasing WC were risk factors for developing bladder cancer in men, independent of confounding variables. However, there was a discrepancy in the trend of bladder cancer development according to BMI between the groups with abdominal obesity and without abdominal obesity.


Bladder cancer Body mass index Waist circumference 


Author contributions

JBC and U-SH conceived and designed the experiments. Choi and Kim performed the experiments. JHK and S-HH were involved in samples recruitment. K-DH analyzed the data. JBC and U-SH wrote the first draft of the manuscript. All the authors reviewed and edited the manuscript and approved the final version of the manuscript.


This research was supported by National Research Foundation of Korea (Grant number: NRF-2015R1C1A1A01051802).

Compliance with ethical standards

Conflict of interest

The authors declare no competing financial interests.

Ethical approval

This study was approved by the Institutional Review Board of the Catholic University of Korea (KC16RISI0944).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Jin Bong Choi
    • 1
  • Jung Ho Kim
    • 2
  • Sung-Hoo Hong
    • 3
  • Kyung-Do Han
    • 4
  • U-Syn Ha
    • 3
    • 5
    Email author
  1. 1.Department of Urology, Bucheon St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  2. 2.Department of UrologyDongnam Institute of Radiological & Medical Sciences, Cancer CenterBusanRepublic of Korea
  3. 3.Department of Urology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  4. 4.Department of Biostatistics, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
  5. 5.The Cancer Research Institute, The Catholic University of KoreaSeoulRepublic of Korea

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