Liss Michael A, White Martha, Natarajan Loki, Parsons J Kellogg
Department of Urology, University of Texas Health Science Center San Antonio, San Antonio, TX.
Biostatistics Shared Resource, Moores Comprehensive Cancer Center, University of California San Diego, La Jolla, CA.
Clin Genitourin Cancer. 2017 Jun;15(3):391-395. doi: 10.1016/j.clgc.2016.11.006. Epub 2016 Dec 1.
The aim of this study was to investigate modifiable lifestyle factors of smoking, exercise, and obesity with bladder cancer mortality.
We used mortality-linked data from the National Health Information Survey from 1998 through 2006. The primary outcome was bladder cancer-specific mortality. The primary exposures were self-reported smoking status (never- vs. former vs. current smoker), self-reported exercise (dichotomized as "did no exercise" vs. "light, moderate, or vigorous exercise in ≥ 10-minute bouts"), and body mass index. We utilized multivariable adjusted Cox proportional hazards regression models, with delayed entry to account for age at survey interview.
Complete data were available on 222,163 participants, of whom 96,715 (44%) were men and 146,014 (66%) were non-Hispanic whites, and among whom we identified 83 bladder cancer-specific deaths. In multivariate analyses, individuals who reported any exercise were 47% less likely (adjusted hazard ratio [HR], 0.53; 95% confidence interval [CI], 0.29-0.96; P = .038) to die of bladder cancer than "no exercise". Compared with never-smokers, current (HR, 4.24; 95% CI, 1.89-9.65; P = .001) and former (HR, 2.95; 95% CI, 1.50-5.79; P = .002) smokers were 4 and 3 times more likely, respectively, to die of bladder cancer. There were no significant associations of body mass index with bladder cancer mortality.
Exercise decreases and current smoking increases the risk of bladder cancer-specific mortality. These data suggest that exercise and smoking cessation interventions may reduce bladder cancer death.
本研究旨在调查吸烟、运动和肥胖等可改变的生活方式因素与膀胱癌死亡率之间的关系。
我们使用了1998年至2006年国家健康信息调查中与死亡率相关的数据。主要结局是膀胱癌特异性死亡率。主要暴露因素包括自我报告的吸烟状况（从不吸烟、曾经吸烟与当前吸烟）、自我报告的运动情况（分为“不运动”与“每次至少运动10分钟的轻度、中度或剧烈运动”）以及体重指数。我们采用多变量调整的Cox比例风险回归模型，并采用延迟进入法来考虑调查访谈时的年龄。
共有222,163名参与者提供了完整数据，其中96,715名（44%）为男性，146,014名（66%）为非西班牙裔白人，我们在这些参与者中确定了83例膀胱癌特异性死亡病例。在多变量分析中，报告进行任何运动的个体死于膀胱癌的可能性比“不运动”的个体低47%（调整后的风险比[HR]为0.53；95%置信区间[CI]为0.29 - 0.96；P = 0.038）。与从不吸烟者相比，当前吸烟者（HR为4.24；95% CI为1.89 - 9.65；P = 0.001）和曾经吸烟者（HR为2.95；95% CI为1.50 - 5.79；P = 0.002）死于膀胱癌的可能性分别高出4倍和3倍。体重指数与膀胱癌死亡率之间无显著关联。
运动可降低膀胱癌特异性死亡率，而当前吸烟会增加该死亡率。这些数据表明，运动和戒烟干预措施可能会降低膀胱癌死亡风险。
