5.15.11.smoking and urologic disease

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  • 1. EMBARGOED FOR RELEASE UNTIL May 15, 2011 AT 10:00 A.M. Contact: Wendy Waldachs Isett, AUA 410-977-4770, wisett@AUAnet.org SMOKING LINKED TO ADVANCED KIDNEY CANCER; BLADDER CANCER DECLINES NOT SEEN IN RESPONSE TO SMOKING CESSATIONWashington, DC -- May 15, 2011– Two new studies that further examine the links between cigarettesmoking and urologic cancers were presented to reporters during a special press conference at theWalter E. Washington Convention Center on May 15, 2011 at 10:00 a.m. during the 106th AnnualScientific Meeting of the American Urological Association (AUA). The session will be moderated by TobyKohler, MD.Cigarette Smoking Is Associated With Advanced Renal Cell Carcinoma (#1256): While cigarette smokingis a recognized risk factor for renal cell carcinoma (RCC) , kidney cancer, researchers from Duke UniversityMedical Center in Durham, NC examined the relationship between smoking and tumor pathology. In aretrospective review of patients undergoing surgery for RCC between 2000 and 2009, researchers foundthat heavier smoking increases the likelihood of advanced disease with a dose dependent effect;cessation reduced the risk of advanced disease. The study examined 845 patients. Current and formersmokers had advanced disease 1.5 to 1.6 times as much as non-smokers. Heavier smoking (longerduration and exposure) was associated with advanced RCC. Quitting reduced the odds of advanceddisease by 9 percent per smoke-free decade.Discordance Between Time Trends of Bladder Cancer Incidence And Cigarette Consumption in The US(#1065): Researchers from the State University of New York Upstate Medical University in Syracuseinvestigated the relationship between trends in bladder cancer incidence and cigarette consumption inthe United States. They discovered by examining data from the Surveillance, Epidemiology and EndResults (SEER) database that, while the rates of lung cancer in the U.S. dropped consistently with the percapita consumption of cigarettes between 1973 and 2007, the rates of bladder cancer did not fall asconsistently.They noted that the decrease of cigarette consumption might have decreased the incidence of bladdercancer, but that this positive effect may have been masked by other factors contributing to a rise inbladder cancer incidences over the last several decades.“These two studies shed new insight into the role that smoking might have for two important urologiccancers.” Dr. Kohler said. “For kidney cancer, it is true that kidney tumors are more often being detectedthese days when they are smaller. However, smoking seems to confer a much greater risk that the cancermay be more aggressive. Cessation of smoking seems to lower the risk. For bladder cancer on the otherhand, the decrease in smoking rates has not impacted the incidence to the same degree that it has for
  • 2. lung cancer, suggesting that there may be other factors which are becoming more important fordevelopment of the disease. ”NOTE TO REPORTERS: Experts are available to discuss this study outside normal briefing times. Toarrange an interview with an expert, please contact the AUA Communications Office at the numberabove or e-mail Communications@AUAnet.org.About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, theAmerican Urological Association is the pre-eminent professional organization for urologists, with more than 17,000members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering thehighest standards of urologic care by carrying out a wide variety of programs for members and their patients. ###
  • 3. 1256CIGARETTE SMOKING IS ASSOCIATED WITH ADVANCED RENAL CELL CARCINOMAMatvey Tsivian, Daniel Moreira, Jorge Caso, Vladimir Mouraviev, Thomas Polascik, Durham, NCINTRODUCTION AND OBJECTIVES: Cigarette smoking is a recognized risk factor for renal cell carcinoma(RCC) but little data is available on the association between smoking and RCC biology. Herein weinvestigated the association between cigarette smoking and RCC stage in a large contemporarymultiethnic surgical cohort.METHODS: Retrospective review of demographic, clinical and pathological data of patients undergoingsurgery for RCC between 2000-2009. Advanced RCC was defined as metastatic disease, pathological stageâ?¥T3 and/or lymph node involvement. Self-reported smoking history included smoking status, duration,intensity, cumulative exposure and cessation. Patient and tumor characteristics were compared betweenthe groups by univariate and multivariate analyses.RESULTS: Of the 845 eligible patients, 19.4% and 29.1% were current and former smokers; 207 (24.5%)patients had advanced disease. In both univariate and multivariate analyses, smoking was consistentlyassociated with advanced RCC and cessation reversed the risk. Current and former smokers had a 1.5 and1.6-fold increased odds of advanced disease. Heavier smoking (longer duration and exposure) wasassociated with increased risk of advanced RCC. Durable cessation reduced the odds of advanced diseaseby approximately 9% per smoking-free decade.CONCLUSIONS: Cigarette smoking is an independent risk factor for advanced RCC. Heavier smokingincreases the likelihood of advanced disease with a dose-dependent effect. Durable smoking cessationattenuated the risk of advanced disease. Given that cigarette smoking is among the few modifiable riskfactors for RCC, our results reinforce the importance of smoking cessation and encourage furtherinvestigation of the association between smoking and RCC biology.Source of Funding: none
  • 4. 1065DISCORDANCE BETWEEN TIME TRENDS OF BLADDER CANCER INCIDENCE AND CIGARETTECONSUMPTION IN THE USJack Cheng-Tsung Hou, Ching Y. Wang, Syracuse, NYINTRODUCTION AND OBJECTIVES: Cigarette smoking is a major cause of cancer of bladder and lung. Weinvestigated the relationship between the trends in bladder cancer incidence and cigarette consumptionin the US.METHODS: The incidences of bladder and lung cancers from 1973 to 2007 and the treatment of prostatecancer from 1988 to 2007 were retrieved from SEER database. Smoking prevalence data were from theAmerican Lung Association. Data of adult (age >= 18 years) per capita consumption of cigarettes werefrom the US Department of Agriculture.RESULTS: The adult per capitaconsumption of cigarettes has been inthe rise since 1900 and it peaked in1963. It has gradually decreased 62%from 1963 to 2006. The adult percapita cigarette tar exposure hasdecreased by more than 80% duringthis period of time. The prevalence ofsmoking in adults has decreased from51.9% to 23.1% in men and 33.9% to18.3% in women from 1965 to 2008.The age-adjusted incidence of lungcancer in men peaked in 1984 and ithas decreased by 31% since then. Thetime trend of lung cancer in men was in concordance with the per capita consumption of cigarettes witha lag time of about 20 years which reflects the latent period for the induction of this cancer. However,there was a lack of concordance between the trends of bladder cancer incidence and cigaretteconsumption in men (Fig. 1). The median ages at diagnosis for the cancer of bladder and lung were 73and 71 years, respectively, suggesting that the latent periods for the induction of both cancers may besimilar. External beam radiation therapy (EBRT) of prostate cancer has been suggested to be associatedwith bladder cancer. However, less than 0.3% of all bladder cancers may be due to EBRT and it might onlymarginally change bladder cancer incidence. The time trends of bladder and lung cancers in women werenot in concordance with per capita consumption of cigarettes.CONCLUSIONS: As expected, the decrease of cigarette consumption is accompanied with the decrease oflung cancer incidence in men. The stable trend of bladder cancer incidence is in discordance withcigarette consumption. The decrease of cigarette consumption might have decreased the incidence ofbladder cancer, but this effect might be masked by other environmental factors that might haveincreasingly contributed to this malignancy during the past several decades.Source of Funding: None