Association between tobacco exposure and bladder cancer recurrence: A systematic review and meta-analysis

doi:10.5662/wjm.v14.i2.91889

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World Journal of Methodology

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Meta-Analysis

World J Methodol. Jun 20, 2024; 14(2): 91889
Published online Jun 20, 2024. doi: 10.5662/wjm.v14.i2.91889

Association between tobacco exposure and bladder cancer recurrence: A systematic review and meta-analysis

Lei Xiang, Qi-Qi Xie, Si-Si Xu, Wen-Jie Ruan, Dong-Hui Xu, Yao-Yao Gan, Jia Zuo, Wen-Jun Xu, Zhi-Peng Li

Lei Xiang, Department of Rehabilitation Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China

Qi-Qi Xie, Si-Si Xu, Wen-Jie Ruan, Dong-Hui Xu, Yao-Yao Gan, Jia Zuo, Wen-Jun Xu, Zhi-Peng Li, School of Medicine, Taizhou University, Taizhou 318000, Zhejiang Province, China

Author contributions: Xiang L wrote the original draft; Xie QQ performed the methodology, software and data organization; Xu SS and Ruan WJ performed the data curation; Xu DH, Gan YY, Zuo J and Xu WJ formally analyzed and wrote the original manuscript; Li ZP for conceptualization, writing, reviewing and editing. All the authors participated in drafting the manuscript, and all the authors read, contributed to, and approved the final version of the manuscript.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest related to this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Zhi-Peng Li, MD, Senior Editor, Surgeon, Teacher, School of medicine, Taizhou University, No. 1139 Shifu Avenue, Jiaojiang District, Taizhou 318000, Zhejiang Province, China. lzpzhonghong@126.com

Received: January 8, 2024
Revised: February 10, 2024
Accepted: March 28, 2024
Published online: June 20, 2024
Processing time: 157 Days and 20.4 Hours

Abstract

BACKGROUND

However, the connection between smoking and the prognosis of patients with bladder cancer remains unclear.

AIM

To determine whether smoking is linked to the recurrence and progression of bladder cancer.

METHODS

As of July 20, 2022, relevant English-language research was identified by searching PubMed, the Web of Science, and the Cochrane Library. We pooled the available data from the included studies using a random effects model. Subgroup analysis and sensitivity analysis were also conducted.

RESULTS

A total of 12 studies were included in this meta-analysis. The combined analysis revealed that tobacco exposure was associated with a significantly greater recurrence rate than nonsmoking status [odd ratios (OR) = 1.76, 95%CI: 1.84-2.93], and the progression of bladder cancer was significantly greater in smokers than in nonsmokers (OR = 1.21, 95%CI: 1.02-1.44). Stratified analysis further revealed that current smokers were more likely to experience relapse than never-smokers were (OR = 1.85, 95%CI: 1.11-3.07). Former smokers also had a greater risk of relapse than did never-smokers (OR = 1.73, 95%CI: 1.09-2.73). Subgroup analysis indicated that non-Caucasians may be more susceptible to bladder cancer recurrence than Caucasians are (OR = 2.13, 95%CI: 1.74-2.61).

CONCLUSION

This meta-analysis revealed that tobacco exposure may be a significant risk factor for both the recurrence and progression of bladder cancer.

Keywords: Smoking; Bladder; Cancer; Recurrence; Progress

Core Tip: In this meta-analysis, 12 studies were included to investigate the connection between smoking and the prognosis of bladder cancer patients. The results showed that tobacco exposure was associated with a significantly greater recurrence rate and faster progression of bladder cancer than nonsmoking status. Subgroup analysis further revealed that current and former smokers had a greater risk of relapse than did never smokers, and non-Caucasians may be more susceptible to bladder cancer recurrence than Caucasians are. Therefore, smoking is a major risk factor for bladder cancer recurrence and progression, and cessation of smoking is recommended. Regular follow-up and treatment are crucial for reducing the risk of smoking.