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Rosiglitazone Use and the Risk of Bladder Cancer in Patients With Type 2 Diabetes

 Eugene Han  ;  Suk-Yong Jang  ;  Gyuri Kim  ;  Yong-ho Lee  ;  Eun Yeong Choe  ;  Chung Mo Nam  ;  Eun Seok Kang 
 MEDICINE, Vol.95(6) : 2786, 2016 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Case-Control Studies ; Diabetes Mellitus, Type 2/complications* ; Diabetes Mellitus, Type 2/drug therapy* ; Female ; Humans ; Hypoglycemic Agents/adverse effects* ; Incidence ; Male ; Middle Aged ; Risk Assessment ; Thiazolidinediones/adverse effects* ; Urinary Bladder Neoplasms/chemically induced* ; Urinary Bladder Neoplasms/epidemiology*
Patients with diabetes have a higher incidence of bladder cancer; however, the association between thiazolidinedione use and bladder cancer risk has been controversial. We aimed to investigate whether pioglitazone or rosiglitazone use is associated with bladder cancer risk in patients with type 2 diabetes mellitus.This nationwide nested case-control study used data set obtained from the Korean National Health Insurance Service National Sample Cohort 2002 to 2013. Among the 47,738 patients with incident diabetes, 85 cases of newly diagnosed bladder cancer and 850 controls (1:10 matched by age, sex, index year, and diabetes diagnosis year) were recruited. Type 2 diabetes mellitus and bladder cancer were diagnosed using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision code.More cases of bladder cancer were diagnosed in men (81.2%), and the stratified age peaked at 70 to 79 years old. Exclusive rosiglitazone use raised the incidence of bladder cancer (odds ratio [OR] = 3.07, 95% confidence interval [CI ] = 1.48-6.37). The risk of bladder cancer started to increase after less than 3 months use (OR = 3.30, 95% CI = 1.02-10.70) and peaked at 3 to 12 months of rosiglitazone use (OR = 4.48, 95% CI = 1.51-13.31). Patients were first exposed to exclusive rosiglitazone within 1 year (OR = 11.74, 95% CI = 2.46-56.12) and those who had consistently used it for 1 year (OR = 4.48 95% CI = 1.51-13.31), had higher risks of bladder cancer compared with nonthiazolidinedione users. Neither pioglitazone use nor exclusive pioglitazone use were associated with an increased incidence of bladder cancer.Rosiglitazone use is associated with an increased risk of incident bladder cancer independent of age and sex in patients with type 2 diabetes mellitus. The highest odds of bladder cancer in rosiglitazone users was seen in those with <1 year of exposure.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Gyuri(김규리)
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Han, Eu Gene(한유진)
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