PMID- 23791436
OWN - NLM
STAT- MEDLINE
DCOM- 20140718
LR  - 20151119
IS  - 1938-0682 (Electronic)
IS  - 1558-7673 (Linking)
VI  - 11
IP  - 4
DP  - 2013 Dec
TI  - Insulin use and smoking jointly increase the risk of bladder cancer mortality in 
      patients with type 2 diabetes.
PG  - 508-14
LID - S1558-7673(13)00080-3 [pii]
LID - 10.1016/j.clgc.2013.04.019 [doi]
AB  - BACKGROUND: Whether insulin use predicts bladder cancer mortality has not been 
      investigated. Furthermore, it is not known whether insulin use and smoking 
      jointly influence the risk. MATERIALS AND METHODS: A total of 86,939 patients 
      (40,014 men, 46,925 women) with type 2 diabetes mellitus (T2DM) and aged >/= 25 
      years in a nationally representative cohort were followed prospectively from 1995 
      to 2006 for bladder cancer mortality. Cox regression was used considering the 
      following independent variables: age, sex, diabetes duration, body mass index, 
      smoking, insulin use, and area of residence. The models were created for patients 
      aged >/= 25 and >/= 65 years, separately; and sensitivity analyses were conducted 
      after excluding (1) patients with duration between onset of diabetes and bladder 
      cancer mortality < 5 years, and (2) patients with diabetes duration at 
      recruitment < 3 years. The joint effect of insulin use and smoking was evaluated. 
      RESULTS: Patients who died of bladder cancer were characterized by older age, 
      male predominance, longer diabetes duration, smoking, and insulin use. In 
      multivariable Cox models, age, male sex, and insulin use were consistently 
      predictive for bladder cancer mortality in all analyses, whereas the other 
      variables were not. The adjusted hazard ratios for bladder cancer mortality for 
      insulin users vs. nonusers ranged from 1.877 to 2.502 in different models (all P 
      values < .05). Insulin use and smoking jointly increased the adjusted hazard 
      ratio to 3.120 (95% confidence interval, 1.329-7.322). CONCLUSIONS: Insulin use 
      is significantly predictive for bladder cancer mortality in patients with T2DM. 
      Insulin use and smoking jointly increase the risk.
CI  - Copyright (c) 2013 Elsevier Inc. All rights reserved.
FAU - Tseng, Chin-Hsiao
AU  - Tseng CH
AD  - Department of Internal Medicine, National Taiwan University College of Medicine, 
      Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal 
      Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of 
      Environmental Health and Occupational Medicine of the National Health Research 
      Institutes, Taipei, Taiwan. Electronic address: ccktsh@ms6.hinet.net.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130620
PL  - United States
TA  - Clin Genitourin Cancer
JT  - Clinical genitourinary cancer
JID - 101260955
RN  - 0 (Insulin)
SB  - IM
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Humans
MH  - Insulin/*adverse effects/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Risk
MH  - Risk Factors
MH  - Sex Factors
MH  - Smoking/*adverse effects
MH  - Surveys and Questionnaires
MH  - Urinary Bladder Neoplasms/*mortality
OTO - NOTNLM
OT  - Bladder cancer
OT  - Insulin
OT  - Mortality
OT  - Taiwan
OT  - Type 2 diabetes mellitus
EDAT- 2013/06/25 06:00
MHDA- 2014/07/19 06:00
CRDT- 2013/06/25 06:00
PHST- 2013/02/26 00:00 [received]
PHST- 2013/04/03 00:00 [revised]
PHST- 2013/04/17 00:00 [accepted]
PHST- 2013/06/25 06:00 [entrez]
PHST- 2013/06/25 06:00 [pubmed]
PHST- 2014/07/19 06:00 [medline]
AID - S1558-7673(13)00080-3 [pii]
AID - 10.1016/j.clgc.2013.04.019 [doi]
PST - ppublish
SO  - Clin Genitourin Cancer. 2013 Dec;11(4):508-14. doi: 10.1016/j.clgc.2013.04.019. 
      Epub 2013 Jun 20.