World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website https://www.wjon.org

Original Article

Volume 14, Number 5, October 2023, pages 382-391

Familial Risk and Interaction With Smoking and Alcohol Consumption in Bladder Cancer: A Population-Based Cohort Study

Figure 2. Association of lifestyle factors with the total study population. CI: confidence interval; DBP: diastolic blood pressure; HR: hazard ratio; SBP: systolic blood pressure.

Figure 3. Combined effect of family history and smoking and alcohol consumption on the risk of bladder cancer. CI: confidence interval; RERI: relative excess risk due to interaction.

**Table 1.** Distribution of Lifestyle Factors Among Individuals With and Without Affected Parents For Bladder Cancer
	With affected parents	Without affected parents	Total	Standardized difference
DBP: diastolic blood pressure; SBP: systolic blood pressure.
Total	37,760		5,486,643		5,524,403
Sex
Male	26,608	70.4	3,542,561	64.6	3,569,169	64.6	0.13
Female	11,152	29.5	1,955,234	35.4	1,955,234	35.4
Year of birth
∼1971	15,013	39.8	1,082,427	19.7	1,097,440	19.9	0.61
1972 - 1981	16,282	43.1	2,155,959	39.3	2,172,241	39.3
1982 - 1991	6,120	16.2	2,039,026	37.2	2,045,146	37.0
1992 - 2001	345	0.9	209,231	3.8	209,576	3.8
Smoking intensity (pack-years)
Non-smoker	15,142	40.1	2,638,151	48.1	2,653,293	48.0	0.27
< 10	11,360	30.1	1,821,137	33.2	1,832,497	33.2
10 to < 20	7,168	19.0	714,447	13.0	721,615	13.1
≥ 20	4,090	10.8	312,908	5.7	316,998	5.7
Alcohol consumption
Non-drinker	6,377	16.9	1,067,761	19.5	1,074,138	19.4	0.13
< 5 drinks (males), < 4 drinks (females) per week or < twice/week	24,648	65.3	3,434,680	62.6	3,459,328	62.6
≥ 5 drinks (males), ≥ 4 drinks (females) per week and ≥ twice/week	4,555	12.1	783,988	14.3	788,543	14.3
Body mass index (kg/m²)
< 18.5	2,000	5.3	388,834	7.1	390,834	7.1	0.14
18.5 to < 23	14,999	39.7	2,426,300	44.2	2,441,299	44.2
23 to < 25	8,180	21.7	1,095,343	20.0	1,103,523	20.0
≥ 25	12,581	33.3	1,576,166	28.7	1,588,747	28.8
Blood pressure (mm Hg)
SBP < 120 and DBP < 80 (reference)	15,008	39.7	2,475,675	45.1	2,490,683	45.1	0.14
SBP ≥ 120 and SBP < 130 and DBP < 80	4,377	11.6	656,293	12.0	660,670	12.0
SBP ≥ 130 and SBP < 140 or DBP ≥ 80 and DBP < 90	13,326	35.3	1,830,605	33.4	1,843,931	33.4
SBP ≥ 140 and SBP < 180 or DBP ≥ 90	4,948	13.1	513,569	9.4	518,517	9.4
SBP ≥ 180 and/or DBP ≥ 120	93	0.2	9,939	0.2	10,032	0.2
Fasting blood glucose (mg/dL)
< 100	34,152	90.4	5,109,735	93.1	5,143,887	93.1	0.10
100 to < 126	2,233	5.9	247,299	4.5	249,532	4.5
≥ 126	1,365	3.6	128,495	2.3	129,860	2.4
Cholesterol (mg/dL)
< 200	24,166	64.0	3,817,195	69.6	3,841,361	69.5	0.12
200 to < 240	10,204	27.0	1,286,276	23.4	1,296,480	23.5
≥ 240	3,340	8.8	372,707	6.8	376,047	6.8

Table 1. Distribution of Lifestyle Factors Among Individuals With and Without Affected Parents For Bladder Cancer

With affected parents

Without affected parents

Total

Standardized difference

DBP: diastolic blood pressure; SBP: systolic blood pressure.

Total

37,760

5,486,643

5,524,403

Sex

Male

26,608

70.4

3,542,561

64.6

3,569,169

64.6

0.13

Female

11,152

29.5

1,955,234

35.4

1,955,234

35.4

Year of birth

∼1971

15,013

39.8

1,082,427

19.7

1,097,440

19.9

0.61

1972 - 1981

16,282

43.1

2,155,959

39.3

2,172,241

39.3

1982 - 1991

6,120

16.2

2,039,026

37.2

2,045,146

37.0

1992 - 2001

345

0.9

209,231

3.8

209,576

3.8

Smoking intensity (pack-years)

Non-smoker

15,142

40.1

2,638,151

48.1

2,653,293

48.0

0.27

< 10

11,360

30.1

1,821,137

33.2

1,832,497

33.2

10 to < 20

7,168

19.0

714,447

13.0

721,615

13.1

≥ 20

4,090

10.8

312,908

5.7

316,998

5.7

Alcohol consumption

Non-drinker

6,377

16.9

1,067,761

19.5

1,074,138

19.4

0.13

< 5 drinks (males), < 4 drinks (females) per week or < twice/week

24,648

65.3

3,434,680

62.6

3,459,328

62.6

≥ 5 drinks (males), ≥ 4 drinks (females) per week and ≥ twice/week

4,555

12.1

783,988

14.3

788,543

14.3

Body mass index (kg/m²)

< 18.5

2,000

5.3

388,834

7.1

390,834

7.1

0.14

18.5 to < 23

14,999

39.7

2,426,300

44.2

2,441,299

44.2

23 to < 25

8,180

21.7

1,095,343

20.0

1,103,523

20.0

≥ 25

12,581

33.3

1,576,166

28.7

1,588,747

28.8

Blood pressure (mm Hg)

SBP < 120 and DBP < 80 (reference)

15,008

39.7

2,475,675

45.1

2,490,683

45.1

0.14

SBP ≥ 120 and SBP < 130 and DBP < 80

4,377

11.6

656,293

12.0

660,670

12.0

SBP ≥ 130 and SBP < 140 or DBP ≥ 80 and DBP < 90

13,326

35.3

1,830,605

33.4

1,843,931

33.4

SBP ≥ 140 and SBP < 180 or DBP ≥ 90

4,948

13.1

513,569

9.4

518,517

9.4

SBP ≥ 180 and/or DBP ≥ 120

0.2

9,939

0.2

10,032

0.2

Fasting blood glucose (mg/dL)

< 100

34,152

90.4

5,109,735

93.1

5,143,887

93.1

0.10

100 to < 126

2,233

5.9

247,299

4.5

249,532

4.5

≥ 126

1,365

3.6

128,495

2.3

129,860

2.4

Cholesterol (mg/dL)

< 200

24,166

64.0

3,817,195

69.6

3,841,361

69.5

0.12

200 to < 240

10,204

27.0

1,286,276

23.4

1,296,480

23.5

≥ 240

3,340

8.8

372,707

6.8

376,047

6.8

**Table 2.** Familial Risk of Bladder Cancer Among Offspring of Affected Parents
	With affected parents	Without affected parents
^aRisk factors include: age, sex, body mass index, blood pressure, cholesterol, fasting blood sugar, pulse pressure, proteinuria, drinking and smoking. HR: hazard ratio; CI: confidence interval.
Number of people at risk	33,244	4,473	37,760	5,486,643
Male	23,358	3,221	26,608	3,542,561
Female	9,886	1,252	11,152	1,944,082
Number of cases	25	4	29	1,283
Person-years	585,412	78,679	664,850	96,707,652
Incidence/10,000 person-years (95% CI)	0.43 (0.29 - 0.63)	0.51 (0.19 - 1.35)	0.44 (0.30 - 0.63)	0.13 (0.13 - 0.14)
Crude HRs (95% CI)	3.32 (2.21 - 4.97)	2.02 (0.51 - 8.10)	3.16 (2.14 - 4.66)	1
HRs (95% CI) adjusted for age and sex	2.26 (1.51 - 3.39)	1.10 (0.27 - 4.41)	2.09 (1.41 - 3.08)	1
HRs (95% CI) adjusted for risk factors^a	2.20 (1.47 - 3.30)	1.09 (0.27 - 4.38)	2.04 (1.38 - 3.01)	1

Table 2. Familial Risk of Bladder Cancer Among Offspring of Affected Parents

With affected parents

Without affected parents

Father

Mother

Total

^aRisk factors include: age, sex, body mass index, blood pressure, cholesterol, fasting blood sugar, pulse pressure, proteinuria, drinking and smoking. HR: hazard ratio; CI: confidence interval.

Number of people at risk

33,244

4,473

37,760

5,486,643

Male

23,358

3,221

26,608

3,542,561

Female

9,886

1,252

11,152

1,944,082

Number of cases

1,283

Person-years

585,412

78,679

664,850

96,707,652

Incidence/10,000 person-years (95% CI)

0.43 (0.29 - 0.63)

0.51 (0.19 - 1.35)

0.44 (0.30 - 0.63)

0.13 (0.13 - 0.14)

Crude HRs (95% CI)

3.32 (2.21 - 4.97)

2.02 (0.51 - 8.10)

3.16 (2.14 - 4.66)

HRs (95% CI) adjusted for age and sex

2.26 (1.51 - 3.39)

1.10 (0.27 - 4.41)

2.09 (1.41 - 3.08)

HRs (95% CI) adjusted for risk factors^a

2.20 (1.47 - 3.30)

1.09 (0.27 - 4.38)

2.04 (1.38 - 3.01)