Glucocorticoid therapy and risk of bladder cancer

Background: Use of immunosuppressive drugs post organ transplantation, and prolonged use of glucorticoids for other conditions have been associated with subsequent risk of certain malignancies, that is, skin cancers and lymphoma. There is evidence that the incidence of bladder cancer is also elevate...

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Bibliographic Details
Published in:British journal of cancer 2009-10, Vol.101 (8), p.1316-1320
Main Authors: Dietrich, K, Schned, A, Fortuny, J, Heaney, J, Marsit, C, Kelsey, K T, Karagas, M R
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Bladder cancer
Cancer Research
Case-Control Studies
Drug Resistance
Epidemiology
Female
Glucocorticoids - adverse effects
Humans
Immunosuppressive Agents - adverse effects
Logistic Models
Male
Medical sciences
Middle Aged
Molecular Medicine
Nephrology. Urinary tract diseases
Oncology
Translational Therapeutics
Tumors of the urinary system
Urinary Bladder Neoplasms - chemically induced
Urinary tract. Prostate gland
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Summary:Background: Use of immunosuppressive drugs post organ transplantation, and prolonged use of glucorticoids for other conditions have been associated with subsequent risk of certain malignancies, that is, skin cancers and lymphoma. There is evidence that the incidence of bladder cancer is also elevated among organ transplant recipients, however, it is unknown whether other groups of patients, that is, those taking oral glucocorticoids, likewise are at an increased risk. Methods: In a population-based case–control study in New Hampshire, USA, we compared the use of glucocorticoids in 786 bladder cancer cases and in 1083 controls. We used unconditional logistic regression analysis to compute adjusted odds ratios (ORs) associated with oral glucocorticoid use. Results: In our analysis, the risk of bladder cancer was related to a history of prolonged oral glucocorticoid use (OR=1.85, 95% CI=1.24–2.76, adjusted for age, gender and smoking). Associations with oral glucocorticoid use were stronger for invasive tumours (OR=2.12, 95% CI=1.17–3.85) and tumours with high (3+) p53 staining intensity (OR=2.35, 95% CI=1.26–4.36). Conclusion: Our results raise the possibility of an increased risk of bladder cancer from systemic use of glucocorticoids, and a potential role of immune surveillance in bladder cancer aetiology.
ISSN:0007-0920
1532-1827
DOI:10.1038/sj.bjc.6605314