A Pooled Analysis of Bladder Cancer Case–Control Studies Evaluating Smoking in Men and Women

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Abstract
Objective A recent study suggested that risk of bladder cancer may be higher in women than in men who smoked comparable amounts of cigarettes. We pooled primary data from 14 case–control studies of bladder cancer from Europe and North America and evaluated differences in risk of smoking by gender. Methods The pooled analysis included 8316 cases (21% women) and 17,406 controls (28% women) aged 30–79 years. Odds ratios (ORs) and 95% confidence intervals (95% CI) for smoking were adjusted for age and study. Exposure-response was evaluated in a stratified analysis by gender and by generalized additive models. Results The odds ratios for current smokers compared to nonsmokers were 3.9 (95% CI 3.5–4.3) for males and 3.6 (3.1–4.1) for females. In 11 out of 14 studies, ORs were slightly higher in men. ORs for current smoking were similar for men (OR = 3.4) and women (OR = 3.7) in North America, while in Europe men (OR = 5.3) had higher ORs than women (OR = 3.9). ORs increased with duration and intensity in both genders and the exposure-response patterns were remarkably similar between genders. Conclusion These results do not support the hypothesis that women have a higher relative risk of smoking-related bladder cancer than men.

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