Department of Urologic Surgery, Biostatistical Consulting Laboratory, University of Minnesota, Minneapolis, MN 55455, USA.
Urol Oncol. 2013 Aug;31(6):862-5. doi: 10.1016/j.urolonc.2011.06.005. Epub 2011 Jul 23.
We evaluated patients with history of previous malignancy to determine risk of an ensuing bladder cancer.
The National Cancer Institute's Surveillance, Epidemiology, and End Results 9 registry database from 1973 to 1999 (SEER) was reviewed for patients with initial primary cancers in oral cavity and pharynx, colon and rectum, respiratory system, breast, prostate, testis, or penis. This group of patients was then examined to identify subsequent separate primary malignancies in the bladder. Comparison was made to the incidence of bladder cancer in the general population to determine a standardized incidence ratio (SIR). Additional analysis was performed based on age at diagnosis, stage, gender, race, and use of external beam radiation for treatment of initial cancer.
A total of 7,289 (0.5%) of patients had a bladder cancer following their initial malignancy. Patients with prostate cancer had the largest increase in risk of bladder cancer with a SIR of 8.24, and all initial cancer groups had an elevated risk of bladder cancer relative to the general population. External beam radiation and non-White gender were associated with an increased risk of bladder cancer. Older age at diagnosis of the initial cancer correlated with a lower risk of subsequent bladder cancer.
This study suggests an increased risk of bladder cancer following a separate initial cancer. Lower threshold for working up those patients for bladder cancer may be warranted.
我们评估了有既往恶性肿瘤病史的患者，以确定随后发生膀胱癌的风险。
回顾了 1973 年至 1999 年期间美国国家癌症研究所的监测、流行病学和结果 9 号登记数据库（SEER）中，口腔和咽、结肠和直肠、呼吸系统、乳腺、前列腺、睾丸或阴茎的初始原发性癌症患者的资料。然后，对这群患者进行了检查，以确定随后是否有单独的原发性膀胱癌。将其与一般人群中膀胱癌的发病率进行比较，以确定标准化发病率比（SIR）。根据诊断时的年龄、分期、性别、种族以及初始癌症的外部束放疗的使用情况，进行了额外的分析。
共有 7289 名（0.5%）患者在初次恶性肿瘤后发生了膀胱癌。前列腺癌患者膀胱癌的风险增加最大，SIR 为 8.24，所有初始癌症组与一般人群相比，膀胱癌的风险均升高。外部束放疗和非白人种性别与膀胱癌风险增加相关。初始癌症诊断时的年龄越大，随后发生膀胱癌的风险越低。
本研究表明，在单独的初始癌症后发生膀胱癌的风险增加。对于这些患者，可能需要更严格地筛查膀胱癌。
