Medical College of Wisconsin
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Smoking status, usual adult occupation, and risk of recurrent urothelial bladder carcinoma: data from The Cancer Genome Atlas (TCGA) Project. Cancer Causes Control 2016 Dec;27(12):1429-1435 PMID: 27804056 PMCID: PMC5114667

Pubmed ID



PURPOSE: Tobacco smoking and occupational exposures are the leading risk factors for developing urothelial bladder carcinoma (UBC), yet little is known about the contribution of these two factors to risk of UBC recurrence. We evaluated whether smoking status and usual adult occupation are associated with time to UBC recurrence for 406 patients with muscle-invasive bladder cancer submitted to The Cancer Genome Atlas (TCGA) project.

METHODS: Kaplan-Meier and Cox proportional hazard methods were used to assess the association between smoking status, employment in a high-risk occupation for bladder cancer, occupational diesel exhaust exposure, and 2010 Standard Occupational Classification group and time to UBC recurrence.

RESULTS: Data on time to recurrence were available for 358 patients over a median follow-up time of 15 months. Of these, 133 (37.2%) experienced a recurrence. Current smokers who smoked for more than 40 pack-years had an increased risk of recurrence compared to never smokers (HR 2.1, 95% CI 1.1, 4.1). Additionally, employment in a high-risk occupation was associated with a shorter time to recurrence (log-rank p = 0.005). We found an increased risk of recurrence for those employed in occupations with probable diesel exhaust exposure (HR 1.8, 95% CI 1.1, 3.0) and for those employed in production occupations (HR 2.0, 95% CI 1.1, 3.6).

CONCLUSIONS: These findings suggest smoking status impacts risk of UBC recurrence, although several previous studies provided equivocal evidence regarding this association. In addition to the known causal relationship between occupational exposure and bladder cancer risk, our study suggests that occupation may also be related to increased risk of recurrence.

Author List

Wilcox AN, Silverman DT, Friesen MC, Locke SJ, Russ DE, Hyun N, Colt JS, Figueroa JD, Rothman N, Moore LE, Koutros S


Noorie Hyun PhD Assistant Professor in the Institute for Health and Equity department at Medical College of Wisconsin


2-s2.0-84994130867   7 Citations

MESH terms used to index this publication - Major topics in bold

Middle Aged
Neoplasm Recurrence, Local
Occupational Exposure
Risk Factors
United States
Urinary Bladder Neoplasms
jenkins-FCD Prod-321 98992d628744e349846c2f62ac68f241d7e1ea70