Abstract
BackgroundIncreasing evidence suggests that diabetes mellitus (DM) may be associated with an increased risk of bladder cancer. To provide a quantitative assessment of this association, we evaluated the relation between DM and incidence and mortality of bladder cancer in an updated meta-analysis of cohort studies. Methods We identified cohort studies by searching the EMBASE and MEDLINE databases, through 31 March 2012. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated with random-effects models.ResultsA total of 29 cohort studies (27 articles) were included in this meta-analysis. DM was associated with an increased incidence of bladder cancer (RR 1.29, 95% CI: 1.08–1.54), with significant evidence of heterogeneity among these studies (p<0.001, I2 = 94.9%). In stratified analysis, the RRs of bladder cancer were 1.36 (1.05–1.77) for diabetic men and 1.28 (0.75–2.19) for diabetic women, respectively. DM was also positively associated with bladder cancer mortality (RR 1.33, 95% CI: 1.14–1.55), with evident heterogeneity between studies (p = 0.002, I2 = 63.3%). The positive association was observed for both men (RR 1.54, 95% CI: 1.30–1.82) and women (RR 1.50, 95% CI: 1.05–2.14).ConclusionThese findings suggest that compared to non-diabetic individuals, diabetic individuals have an increased incidence and mortality of bladder cancer.
Highlights
Bladder cancer is one of the most common malignancies of the urinary tract
A previous meta-analysis of 16 studies conducted in 2006 showed that diabetes was associated with an increased risk of bladder cancer in case-control studies and cohort studies, but not in cohort studies of diabetic patients [14]
We aim to analyze the relation between diabetes mellitus (DM) and incidence and mortality of bladder cancer in an updated metaanalysis of cohort studies
Summary
Bladder cancer is one of the most common malignancies of the urinary tract. Based on incidence and mortality data from several agencies, the American Cancer Society estimates that 73,510 new bladder cancer cases and 14,880 deaths from bladder cancer are projected to occur in the United States in 2012 [1]. A number of studies have found that diabetes may be associated with increased risk of a variety of cancers, including cancers of the pancreas [10], liver [11], kidney [12], colon and rectal [13]. We aim to analyze the relation between DM and incidence and mortality of bladder cancer in an updated metaanalysis of cohort studies. This updated analysis of 29 cohort studies will allow us to provide more precise risk estimates than the previous analysis. To provide a quantitative assessment of this association, we evaluated the relation between DM and incidence and mortality of bladder cancer in an updated meta-analysis of cohort studies
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