Studies Highlight Bladder Cancer Risk for Diabetic Smokers, According to Cancer Monthly

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Two recent studies illustrate the danger of smoking, especially among diabetics who take insulin.

Smoking and Bladder Cancer Risk in Diabetes

Together, insulin use and smoking increase the [bladder cancer] risk further.

New research studies conducted in Taiwan and Turkey and reported by Cancer Monthly show that the risk of bladder cancer is exacerbated by smoking. The risk was even higher among diabetics who were on insulin.

Evidence suggests that people with type 2 diabetes face a higher risk of bladder cancer than the general public (“Bladder Cancer and diabetes,” Diapedia,, but certain drugs and other agents can compound the risk. A study published in Clinical Genitourinary Cancer followed the cases of more than 86,000 patients with type 2 diabetes from 1995 to 2006 to evaluate the joint effect of insulin use and smoking.

Patients who died of bladder cancer were typically older men who had had diabetes for many years and who both smoked and used insulin. Author CH Tseng of the Taiwan University College of Medicine reports, “The adjusted hazard ratios for bladder cancer mortality for insulin users vs. nonusers ranged from 1.877 to 2.502…Insulin use and smoking jointly increased the adjusted hazard ratio to 3.120.” Tseng concludes that insulin use is “significantly predictive for bladder cancer mortality” and that, together, insulin use and smoking increase the risk further.

Another study published in the European Journal of Cancer Prevention analyzed the cases of 173 patients with bladder cancer and compared them with 282 control subjects who did not have bladder cancer. The patients had all been admitted to a Turkish hospital in 2011 for a variety of diseases.

For patients who smoked fewer than 20 cigarettes a day, the odds ratio for developing bladder cancer was 2.9. For heavy smokers (more than 20 cigarettes a day), the odds ratio was 4.0. The researchers conclude, “Tobacco is the major risk factor for bladder cancer in Manisa, being responsible for 56% of cases.” The studies highlight the importance of not smoking as a way to manage bladder cancer risk which is especially relevant for people with type 2 diabetes.

The original studies were published in Clinical Genitourinary Cancer (Tseng, CH, “Insulin use and smoking jointly increase the risk of bladder cancer mortality in paitients with type 2 diabetes”, December 2013, Clinical Genitourinary Cancer, pp. 508-514, and the European Journal of Cancer Prevention. (Erdurak, K, et al, “Smoking, occupation, history of selected diseases and bladder cancer risk in Manisa, Turkey”, January 2014, European Journal of Cancer Prevention, pp. 58-61,

For over ten years, Cancer Monthly has been the only centralized source of cancer treatment results. Patients can see the actual survival rate, quality-of-life indicators, and other key data for approximately 1,500 different cancer treatments. Cancer Monthly provides timely and ground-breaking news on the causes, diagnoses and treatments of the most common cancers including Bladder, Brain, Breast, Colon, Kidney (Renal), Liver, Lung (NSCLC), Ovarian, Prostate and Rectal Cancers, Melanoma, Mesothelioma, and Non-Hodgkin's Lymphoma. Written for patients and their loved ones, Cancer Monthly helps families make more informed treatment decisions.

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Michael Ellis
Cancer Monthy
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