Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses

被引:149
作者
Al-Zalabani, Abdulmohsen H. [1 ]
Stewart, Kelly F. J. [2 ]
Wesselius, Anke [2 ]
Schols, Annemie M. W. J. [3 ]
Zeegers, Maurice P. [2 ]
机构
[1] Taibah Univ, Dept Family & Community Med, Coll Med, POB 42317, Madinah 41541, Saudi Arabia
[2] Maastricht Univ, Med Ctr, Sch Nutr & Translat Res Metab NUTRIM, Dept Complex Genet, POB 616, NL-6200 MS Maastricht, Netherlands
[3] Maastricht Univ, Med Ctr, Sch Nutr & Translat Res Metab NUTRIM, Dept Resp Med, POB 616, NL-6200 MS Maastricht, Netherlands
关键词
Bladder cancer; Prevention; Risk factors; Lifestyle; Obesity; Occupation; Smoking; POLYCYCLIC AROMATIC-HYDROCARBONS; DOSE-RESPONSE METAANALYSIS; FEMALE FLIGHT ATTENDANTS; URINARY-TRACT CANCERS; CIGARETTE-SMOKING; TEA CONSUMPTION; VITAMIN-D; OCCUPATIONAL-EXPOSURE; COFFEE CONSUMPTION; TOBACCO SMOKING;
D O I
10.1007/s10654-016-0138-6
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Each year, 430,000 people are diagnosed with bladder cancer. Due to the high recurrence rate of the disease, primary prevention is paramount. Therefore, we reviewed all meta-analyses on modifiable risk factors of primary bladder cancer. PubMed, Embase and Cochrane database were systematically searched for meta-analyses on modifiable risk factors published between 1995 and 2015. When appropriate, meta-analyses (MA) were combined in meta-meta-analysis (MMA). If not, the most comprehensive MA was selected based on the number of primary studies included. Probability of causation was calculated for individual factors and a subset of lifestyle factors combined. Of 1496 articles identified, 5 were combined in MMA and 21 were most comprehensive on a single risk factor. Statistically significant associations were found for current (RR 3.14) or former (RR 1.83) cigarette smoking, pipe (RR 1.9) or cigar (RR 2.3) smoking, antioxidant supplementation (RR 1.52), obesity (RR 1.10), higher physical activity levels (RR 0.86), higher body levels of selenium (RR 0.61) and vitamin D (RR 0.75), and higher intakes of: processed meat (RR 1.22), vitamin A (RR 0.82), vitamin E (RR 0.82), folate (RR 0.84), fruit (RR 0.77), vegetables (RR 0.83), citrus fruit (RR 0.85), and cruciferous vegetables (RR 0.84). Finally, three occupations with the highest risk were tobacco workers (RR 1.72), dye workers (RR 1.58), and chimney sweeps (RR 1.53). The probability of causation for individual factors ranged from 4 to 68 %. The combined probability of causation was 81.8 %. Modification of lifestyle and occupational exposures can considerably reduce the bladder cancer burden. While smoking remains one of the key risk factors, also several diet-related and occupational factors are very relevant.
引用
收藏
页码:811 / 851
页数:41
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