Table 3.
Hazard Ratio of bladder cancer subtypes, according to diabetes characteristics in age-sex-adjusted and multivariable-adjusted analyses, Netherlands Cohort Study
| Diabetes characteristics | Person- years subcohort | Overall bladder cancer | Invasive bladder cancer | Noninvasive bladder cancer | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Cases | Age-sex-adjusted | Multivariable-adjusted | Cases | Age-sex-adjusted | Multivariable-adjusted | Cases | Age-sex-adjusted | Multivariable-adjusted | ||
| n | HR (95% CI) | HR (95% CI) | n | HR (95% CI) | HR (95% CI) | n | HR (95% CI) | HR (95% CI) | ||
| T2DM status | ||||||||||
| No DM | 69,455 | 2031 | 1 (Ref) | 1 (Ref) | 973 | 1 (Ref) | 1 (Ref) | 1058 | 1 (Ref) | 1 (Ref) |
| T2DM | 2051 | 71 | 1.23 (0.87–1.73) | 1.28 (0.90–1.82) | 43 | 1.51 (1.02–2.24) | 1.57 (1.04–2.37) | 28 | 0.95 (0.61–1.50) | 0.99 (0.63–1.56) |
| P-interaction by sex | 0.944 | 0.214 | < 0.001 | |||||||
| Age at diagnosis of T2DM | ||||||||||
| No DM | 69,455 | 2031 | 1 (Ref) | 1 (Ref) | 973 | 1 (Ref) | 1 (Ref) | 1058 | 1 (Ref) | 1 (Ref) |
| T2DM, diagnosed 55+ years | 1136 | 41 | 1.34 (0.85–2.11) | 1.45 (0.90–2.35) | 29 | 1.90 (1.16–3.13) | 2.11 (1.24–3.61) | 12 | 0.78 (0.40–1.51) | 0.83 (0.42–1.63) |
| T2DM, diagnosed 50–< 55 years | 484 | 13 | 0.86 (0.42–1.77) | 0.81 (0.38–1.71) | 5 | 0.69 (0.25–1.87) | 0.63 (0.23–1.76) | 8 | 1.02 (0.44–2.36) | 0.99 (0.42–2.32) |
| T2DM, diagnosed < 50 years | 431 | 17 | 1.41 (0.68–2.91) | 1.50 (0.72–3.12) | 9 | 1.54 (0.66–3.59) | 1.60 (0.67–3.81) | 8 | 1.29 (0.53–3.15) | 1.39 (0.57–3.41) |
| P-trend | 0.323 | 0.269 | 0.147 | 0.140 | 0.847 | 0.740 | ||||
| P-interaction by sex | 0.742 | < 0.001 | < 0.001 | |||||||
| Time since T2DM diagnosis | ||||||||||
| No DM | 69,455 | 2031 | 1 (Ref) | 1 (Ref) | 973 | 1 (Ref) | 1 (Ref) | 1058 | 1 (Ref) | 1 (Ref) |
| T2DM, < 5 years | 676 | 29 | 1.59 (0.89–2.83) | 1.6 (0.87–2.95) | 21 | 2.35 (1.26–4.36) | 2.39 (1.22–4.69) | 8 | 0.86 (0.37–1.98) | 0.85 (0.36–2.00) |
| T2DM, 5- < 10 years | 657 | 20 | 1.18 (0.66–2.11) | 1.25 (0.69–2.27) | 9 | 1.07 (0.50–2.30) | 1.17 (0.54–2.55) | 11 | 1.28 (0.63–2.59) | 1.33 (0.65–2.72) |
| T2DM, 10+ years | 718 | 22 | 0.97 (0.54–1.76) | 1.02 (0.56–1.88) | 13 | 1.17 (0.59–2.32) | 1.20 (0.59–2.44) | 9 | 0.78 (0.36–1.71) | 0.85 (0.38–1.87) |
| P-trend | 0.553 | 0.417 | 0.217 | 0.179 | 0.783 | 0.953 | ||||
| P-interaction by sex | 0.666 | 0.058 | < 0.001 | |||||||
| T2DM medication | ||||||||||
| No DM | 69,455 | 2031 | 1 (Ref) | 1 (Ref) | 973 | 1 (Ref) | 1 (Ref) | 1058 | 1 (Ref) | 1 (Ref) |
| T2DM without antidiabetic drugs | 1086 | 34 | 1.08 (0.67–1.74) | 1.13 (0.70–1.84) | 16 | 1.03 (0.57–1.88) | 1.11 (0.60–2.04) | 18 | 1.13 (0.63–2.01) | 1.16 (0.65–2.08) |
| T2DM + blood glucose lowering drugs | 757 | 29 | 1.33 (0.78–2.29) | 1.35 (0.76–2.40) | 22 | 2.08 (1.17–3.71) | 2.06 (1.10–3.85) | 7 | 0.63 (0.27–1.46) | 0.65 (0.27–1.53) |
| T2DM + insulin and analogues | 189 | 7 | 2.04 (0.71–5.84) | 1.94 (0.61–6.17) | 5 | 2.82 (0.90–8.80) | 2.65 (0.76–9.18) | 2 | 1.20 (0.25–5.91) | 1.17 (0.22–6.19) |
| P-interaction by sex | < 0.001 | < 0.001 | < 0.001 | |||||||
| T1DM | ||||||||||
| No DM | 69,455 | 2031 | 1 (Ref) | 973 | 1 (Ref) | 1058 | 1 (Ref) | |||
| T1DM | 106 | 6 | 3.14 (0.81–12.12) | 4 | 4.42 (1.05–18.59) | 2 | 1.99 (0.33–11.91) | |||
| P-interaction by sex | 0.726 | 0.949 | < 0.001 | |||||||
DM diabetes mellitus, T2DM type 2 diabetes mellitus, T1DM type 1 diabetes mellitus, HR hazard ratio
Multivariable analyses adjusted for: age at baseline (years), sex (men, women), smoking status (never, former, current), smoking frequency (number of cigarettes per day; centered), smoking duration (number of years; centered), BMI at baseline (< 18.5, 18.5–< 25, 25–< 30, ≥ 30 kg/m2), highest level of education (primary school or lower vocational (low), secondary school or medium vocational (medium), and higher vocational or university (high)), alcohol intake (g/day), family history of bladder cancer (no, yes)