Risk of prostate and bladder cancers in patients with spinal cord injury: a population-based cohort study

Wen-Yuan Lee; Li-Min Sun; Cheng-Li Lin; Ji-An Liang; Yen-Jung Chang; Fung-Chang Sung; Chia-Hung Kao

doi:10.1016/j.urolonc.2013.07.019

Risk of prostate and bladder cancers in patients with spinal cord injury: a population-based cohort study

Urol Oncol. 2014 Jan;32(1):51.e1-7. doi: 10.1016/j.urolonc.2013.07.019. Epub 2013 Nov 13.

Authors

Wen-Yuan Lee¹, Li-Min Sun², Cheng-Li Lin³, Ji-An Liang⁴, Yen-Jung Chang², Fung-Chang Sung⁵, Chia-Hung Kao⁶

Affiliations

¹ China Medical University Hospital Taipei Branch, Taipei, Taiwan; Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
² Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
³ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Institute of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
⁴ Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.
⁵ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁶ Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: [email protected].

PMID: 24239459
DOI: 10.1016/j.urolonc.2013.07.019

Abstract

Objective: To evaluate the risk of prostate and bladder cancers in patients with spinal cord injury (SCI).

Materials and methods: We used data obtained from the National Health Insurance system of Taiwan for this study. The SCI cohort contained 54,401 patients with SCI, and each patient was randomly frequency matched with 4 people from the general population (without SCI) based on age, sex, and index date. Incidence rates, SCI cohort to non-SCI cohort rate ratios, and hazard ratios were measured to evaluate the cancer risks.

Results: Patients with SCI showed a significantly lower risk of developing prostate cancer compared with subjects without SCI (adjusted hazard ratio = 0.73; 95% confidence interval = 0.59, 0.90), after accounting for the competing risk of death. No significant difference in the risk of bladder cancer emerged between the SCI and control groups. Further analyses found a higher spinal level of SCI tended to predict a lower risk for prostate cancer.

Conclusions: Patients with SCI incurred a lower risk for prostate cancer compared with people without SCI. The risk for bladder cancer did not differ between people with or without SCI.

Keywords: Bladder cancer; Cohort study; Prostate cancer; Spinal cord injury.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Aged
Cohort Studies
Databases, Factual / statistics & numerical data
Female
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
National Health Programs / statistics & numerical data
Population Surveillance / methods
Proportional Hazards Models
Prostatic Neoplasms / complications*
Prostatic Neoplasms / epidemiology
Risk Assessment / methods
Risk Assessment / statistics & numerical data
Risk Factors
Spinal Cord Injuries / complications*
Taiwan / epidemiology
Time Factors
Urinary Bladder Neoplasms / complications*
Urinary Bladder Neoplasms / epidemiology